Maternal and perinatal outcomes in eclampsia: a retrospective analysis in a referral hospital

Abstract

Background: Eclampsia is defined as the development of convulsions and / or unexplained coma during pregnancy or postpartum in patients with signs and symptoms of preeclampsia. The objective of present study was to investigate the incidence of eclampsia, the clinical profile, maternal and perinatal outcomes in eclamptic patients in our hospital setting.Methods: The retrospective analysis of case records of all eclampsia cases was done over a period of one year, in department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.Results: The incidence of eclampsia was13.04/1000 deliveries. Eclampsia was more common in the age group 20-24 years (55.64%), primigravidae (62.90%) and patients from rural areas (76.61%). Majority (91%) of women were referred from different hospitals. 112 (90.32%) patients were unbooked. 74 (59.67%) patients developed eclampsia during antenatal period before onset of labor. 67.01% patients presented at gestational age > 37 weeks. Lower segment caesarean section was the predominant mode of delivery in 66 (68.04%) patients. 11.29% patients required ventilatory support and pulmonary edema developed in 4.83% of cases. Maternal death occurred in 7.25% of cases.with a case fatality rate of 16.07%. Pulmonary edema was the commonest cause of death. 7 (5.6%) patients presented with intrauterine death on admission. There were 5 (4.06%) perinatal deaths reported in present study.Conclusions: Eclampsia is still a common and serious complication of pregnancy. Proper antenatal care, detection of preeclampsia with early management and timely referral of high - risk patients, administration of MgSO4 in correct doses and properly timed caesarean section in selected cases would reduce the incidence of eclampsia associated maternal and perinatal morbidity and mortality in our facility.