Eclampsia-the incidence, maternal, perinatal morbidity and mortality

ABSTRACT

The paper was designed to evaluate the incidence, maternal and perinatal morbidity and mortality of Eclampsia. This study includes thirty patients admitted from 1st January 1994 to 31 st December, 2003. The incidence of eclampsia was studied retrospectively. Record of all cases were available for the management, maternal and perinatal outcome. Epilepsy or other conclusive disorders were excluded. Incidence of eclampsia was 6.3 per 10,000 deliveries or 1 132.8 deliveries [0.75%] in our study. Most of them were young, primigravida, unbooked, referred cases and belonged to low socioeconomic class. The age range was 15-40 years, with a peak incidence in the third decade. Gestational age was 28-40 weeks with mean of 36 weeks. Mean fit admission delivery interval, mean admission delivery was 8 and 4.8 hours respectively. Most commonly patients had intrapartum eclampsia. Mean systolic and diastolic blood pressure was 167.2 mm Hg and 108.2 mmHg. Magnesium sulphate was used in 30% and diazepam in the rest of the cases. Seizure control was excellent with magnesium sulphate. Side effects were minimal and consciousness was regained. Hydralazine was the drug of choice as an antihypertensive. The caesarean section was the common mode of delivery [56.6%]. 7tventy-seven patients were discharged in satisfactory position, one left against advice and two expired. The maternal mobidity was observed in 22 cases. This includes coagulation failure, abruptio placenta, HELLP syndrome pulmonary edema and post partum psychosis. Maternal mortality ratio was 0.50 and perinatal mortality ratio was 1.25. Eclampsia is a life threatening obstetric emergency. Meternal and perinatal morbidity and mortality is quite high. Prompt and urgent efforts are essential aiming to prevent, detect and manage eclampsia