Eclampsia, a Major Burden on Maternal and Child Health: A Retrospective Study in Tertiary Care Centre

Abstract

BACKGROUND Eclampsia is very common obstetric emergency and major cause of both maternal and perinatal morbidity and mortality in India. AIM The aim of study was to evaluate its incidence, clinical profile and maternal and perinatal morbidity and mortality associated with it in our hospital. MATERIALS AND METHODS A retrospective study was conducted in Government medical college, Haldwani from August 2014 to July 2015 for a period of one year. Out of 3432 deliveries a total of 53 cases of eclampsia were admitted .Cases were studied with respect to age, parity, period of gestation, blood pressure at the time of admission, severity of proteinuria ,maternal complications and mortality, mode of delivery and perinatal outcome. RESULTS Incidence of eclampsia in our study was 1.45%. Majority of patient were primigravida (62.26%) It was more common in age group of 21 to 25 years (43.39%) followed by age group of 26 to 30 years (26.41%).In most of patient first episode of convulsion occurred at term pregnancy with gestational age more than 37 weeks in our study (52.83%).Among 53 patients of eclampsia 48 presented with antepartum eclampsia (90.57%) and 5 presented as postpartum eclampsia (9.43%). There was no case of intrapartum eclampsia in our study. Most common mode of delivery was Lower Segment Caesarean Section (62.26%) in our study. Among 53 cases of eclampsia 3 patient had pulmonary oedema, 3 patient developed postpartum pyrexia and 4 patient had placental abruption. In one case postpartum haemorrhage occurred and one patient was in acute renal failure. There was one maternal mortality in our study. 6 patient had intrauterine foetal death (11.32%). 25 had preterm delivery (47.16%) and 16 newborns were of low birth weight less than 2.5 Kilograms (30.19%). Most patient who developed eclampsia were unbooked or had irregular or no antenatal checkup (94.33%). CONCLUSION Improvement in antenatal care and neonatal facilities is of paramount importance in decreasing the incidence of eclampsia and improving maternal and perinatal outcome.

Maternal Serum Uric Acid as a Predictor of Severity of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

“…Furthermore, in our study, it was found that eclampsia was more commonly observed in primigravida (65.38%) as compared to multigravida (34.61%), whereas pre-eclampsia and gestational hypertension was more prevalent in multigravida as compared to primigravida. This was similar to the results of a recent study which reported that majority of patient with eclampsia were primigravida (62.26%) of age group 21 to 25 years (43.39%) [26]. Similar results were reported by various other studies also which found that eclampsia is more common in primigravida as compared to multigravida patients [27, 28].…”

“…In women with gestational hypertension 14.29% (5/35) cases had primary section. Similar results were reported by a recent study where the most common mode of delivery for women with severe HDP was LSCS (62.26%) [26]. This was supported by various other studies which found that the induction of labor or cesarean section rates among women with severe HDP was 5 times higher than that of normotensive women [33, 34].…”

Structural equation modeling on the relationship between maternal characteristics and pregnancy complications: A study based on National Family Health Survey

“…The present study demonstrates that women who received full ANC were less likely to experience pregnancy complications. Previous research also found that eclampsia was more common among women who did not receive proper ANC, and that deaths related to eclampsia were higher among illiterate women, those in the younger age group, and those with a lower socioeconomic status 9,15 . The plausible reason for that is that early intervention is more effective than waiting over and treating the disease 40 .…”

“…(2010) indicates that being older than 35 years, not having a partner, being a primipara and having had a caesarean section in the previous pregnancy were factors independently associated with the occurrence of severe maternal complications 13 . Another study reported that death due to eclampsia commonly occurred in the younger age group of 19–24 years, that primigravida and eclampsia related deaths were mostly seen in illiterate and unlooked cases, 14 and that the majority of eclampsia deaths occurred in patients who had not received proper antenatal care 15 . Moreover, women who exposed to substance use were at high risk of maternal complications like preterm low birthweight and postpartum hemorrhage 16 .…”