An Observational Study of Atypical Eclampsia and Its Management in Tertiary Care Center of Central India

Abstract

Background: Eclampsia is development of convulsions and/or unexplained coma at more than 20 weeks gestation and /or less than 48 hours after delivery.In case if eclampsia occurs before 20 weeks or after 48 hours postpartum or in absence of typical signs of hypertension and/or proteinuria, it is called atypical eclampsia. Diagnosis and management of these cases is a challenge for obstetricians. Method: An observational Prospective study conducted in the Department of Obstetrics and Gynecology, M.G.M. Medical College and M.Y.H. Hospital Indore, from Jan 2019 - Dec 2019. Data was collected regarding the relationship of the patients first seizure to delivery interval, prodromal symptoms, use of magnesium sulfate, antihypertensive therapy and follow up medical care. Results: Total 284 eclampsia patient were admitted in the year, of which 59 (20.7%) of these patient showed atypical feature.Moratlity in eclampsia patient in the year was 34 out of the total 96 maternal death i.e. 35.41% in year. Out of these 34eclamptic deaths, death due to atypical eclampsia was 09 i.e. 26.47%.Main cause of mortality in both eclampsia and atypical form was Pulmonary edema. Conclusion: We recommend that health care providers in obstetric practice should have a high index of suspicion for the potential atypical clinical manifestations of eclampsia, irrespective of gestational age at the time of onset or the number of days after delivery, prodromal symptoms, gestational hypertension or pre eclampsia or proteinuria. Obstetricians should be aware of atypical presentations, maintain a high level of suspicion, and be ready to take immediate steps.