Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.

Introduction: Caesarean section (CS) is one of the most common obstetric procedures worldwide and an increased rate of caesarean section has been observed in recent studies. Maternal mortality and morbidities associated with repeat caesarean section is an important health problem worldwide.The present study aims at knowing the various intraoperative complications encountered during repeat caesarean sections with respect to those undergoing primary CS. Materials & Methods: A total of 200 patients who underwent delivery by CS at a tertiary care centre were included in the study. They was then divided into: Group A(100 women undergoing primary CS) and Group B (100 women undergoing repeat CS). Feto-maternal results and intra-op surgical complications were evaluated and compared between the groups. Results:The mean age of the study subjects was 26.94 years with subjects of repeat CS being significantly older (28.67 vs 25.21 years; p<0.05). Time taken for surgery was significantly long in repeat CS group (55.43 vs 46.89 mins; p<0.05). Complications like presence of Adhesions and thinning of scar was seen in 35% and 19% of the subjects with previous CS (p<0.05). Conclusion: An increasing number of CSs is accompanied by serious maternal complications. Decreasing the number of cesarean sections is required to decrease relevant complications. Vaginal birth after CS is an option that should be recommended to the patient.

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BACKGROUNDHypertensive disorder of pregnancy is the foremost cause of maternal deaths in developed countries and the third most common cause of death in developing countries. Eclampsia alone accounts for 50,000 maternal deaths worldwide, annually. Collaborative trial in 1995 conclusively proved that Magnesium Sulphate is the preferred treatment for eclamptic fits. Commonly used regimens are the IM MgSO4 regimen popularized by Pritchard and, the IV MgSO4 regimen popularized by Zuspan. The present study was done with an aim to compare IM Magnesium Sulphate regimen with IV Magnesium Sulphate regimen with regard to prevention of recurrence of seizure and maternal and fetal outcome. MATERIAL AND METHODSAfter institutional ethical committee approval and obtaining informed consent from patients, 100 patients presenting with eclamptic fits reporting to our centre were included in the study and were randomly allocated to one of the following groups. Group I. M.: Received a loading dose of 4 gm IV MgSO4 over 5-10 minutes +5 gm MgSO4 deep intramuscular injection in each buttock and a maintenance dose of 5 gm MgSO4 deep intramuscular injection in alternate buttock every 4 hourly. Group I.V.: Received MgSO4 4gm slow IV over 5-10 minutes as loading dose and 1 gm MgSO4 per hour as continuous intravenous maintenance infusion. RESULTSBoth the treatment regimens were comparable with regard to recurrence of convulsions. 3 (6%) patients in Group IM and 2 (4%) patients in Group IV developed convulsions after initiation of treatment, p value 0.646. Incidence of loss of knee jerk was significantly higher in Group IM as compared to group IV; 7 (14%) in Group IM versus 1 (2%) in Group IV, p value 0.027. Incidence of other parameters of toxicity were comparable between the groups. Maternal and fetal outcome were poor in both the groups but were comparable and no significant differences were observed between the groups. CONCLUSIONBoth IM and IV regimen are equally effective in controlling the recurrence of eclamptic fits. IM Magnesium Sulphate is associated with a higher incidence of toxicity as evidenced by significantly higher incidence of loss of knee jerk reflux.