Eclampsia- A Retrospective Study in a Tertiary Care Centre of Rural Bihar

Abstract

BACKGROUND Eclampsia is an acute and life-threatening obstetric emergency associated with significant maternal and foetal morbidity and mortality. The aim of the study is to evaluate the incidence, management, perinatal and maternal morbidity and mortality in eclampsia patients. METHODS This is a retrospective study conducted over a period of two years from January 2017 to December 2019 at a tertiary care hospital. Details and data obtained from the records were analysed. Out of 14594 deliveries conducted at the hospital, 300 cases of eclampsia were selected. All pregnant women presenting with antepartum, intrapartum and postpartum eclampsia were included in the study. Patients with diabetes mellitus and other chronic medical diseases were excluded. RESULTS The incidence of eclampsia in our study was 2.06%. Majority of patients were in the age group of 21 to 25 years (60.6%). Among 300 patients, 57% patients were primigravidae, 43% patients were multigravidae, 80% patients presented with antepartum eclampsia, 5% with intrapartum eclampsia and 15% with postpartum eclampsia. The commonest mode of delivery was caesarean section in 84.3% patients. The perinatal mortality was 6.3% and maternal mortality was 1.6%. MgSO4 was used for treating convulsions. No complications were noted in 242 (80.6%) patients, while 18 (6%) had HELLP syndrome, 5 (1.6%) had acute renal failure, 5 (1.6%) had pulmonary oedema, 4 (1.3%) had DIC and 5 (1.6%) deaths occurred. Apgar score of 7 to 10 was noted in 198 (66%) babies and 211 (70.3%) were preterm. There were 16 (5.3%) IUD and 3 (1%) still births. CONCLUSIONS Eclampsia is a prime aetiological factor for maternal and foetal morbidity and mortality. However, with early recognition, an improvement in antenatal care, upgrading the neonatal facilities and early delivery by caesarean section can improve the perinatal outcome. Low dose MgSO4 is effective in controlling convulsions in eclampsia.