Eclampsia in African Milieu, Yaounde-Cameroon: epidemiology, seasonal variations and treatment regimen

Abstract

Background: In our context, eclampsia is a major cause of maternal death. Patients are often sent to referral hospitals for optimal care because of the scarcity of resources in peripheral health facilities. We study characteristics of eclampsia the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) in order to prioritize our resources. Methodology: We carried out a retrospective cross-sectional descriptive study from December 2017 to April 2018 at YGOPH. All women managed for eclampsia over the preceding 10 years, from May 1st 2008 to April 30th 2018, were included in the study. We evaluated the seasons of disease occurrence, socio-demographic and clinical characteristics on admission and treatment regimen. We analysed our data using Epi info 7.0. Results: The frequency of eclampsia was 0.96% (151/25680). The mean age of patients was 23.95±6,02 years. Singles (73.5%), housewives (40.4%) and nulliparous patients (54.9%) were the most represented. The disease occurred more frequently during the major rainy season (43.7%). Patients were most often referred cases (70.2%). Eclampsia occurred mostly antepartally (70.3%). Hypertension was most often severe (83.45%). Nicardipine was the most used antihypertensive medication (76.8%) and magnesium sulphate was the anti-convulsant of choice (98.0%). The majority of women delivered by caesarean section (77.8%). HELLP syndrome was the most common maternal complication (9.9%), while prematurity was the most frequent fetal complication (58.9%). The maternal and neonatal mortality rates were 8.6% and 24.4%, respectively. Conclusion: Eclampsia remains an important cause for concern as it results in non-negligible morbidity and mortality. It is therefore important to promote and reinforce antenatal care for pregnant women while taking into consideration the seasonal variations of the disease.