Maternal and Fetal Outcome in Eclampsia

Abstract

Background: (1)To study maternal outcome in eclampsia in relation to respiratory complications, fever, DIC, renal system affection and electrolyte imbalance. (2) To study the fetal outcome in eclampsia in relation to small for gestational age, intrauterine death, neonatal mortality, perinatal mortality and need for NICU admission.Study Design: It was a crosssectional prospective study conducted at Government Medical College Nagpur over a period of 3 months (14 May to 14 July). Methods: The study was approved by the Institutional ethical committee. All patients admitted in the department of obstetrics and gynaecology at government medical college Nagpur with eclampsia was enrolled for the study as per the criteria given. It was a a cross-sectional prospective study conducted from 14 May to 14 July (3 months) on women admitted with eclampsia after the gestational age of 20 weeks and presented with convulsions. The outcome in relation to maternal and neonatal morbidity and mortality was studied on the basis of various complications and defined parameters. Result: A total of 43 patients were enrolled in the study. The most common age group of patients who had eclampsia after 20 weeks of gestation belonged to age group of 21-25 years followed by more than 25 years and the least common age group was between 18-20 years of age. The mean age was found to be 24.23 years. Out of the studied cases 21 (48.83%) were primigravida and 22 (51.16%) were multigravidae. 16 (37.20%) patients visited doctor for ANC visits once or twice while 8 (18.60%) patients visited the doctor thrice, 9 patients made 4 ANC visits while 10 patients were such that they didn't made even a single ANC visit before getting admitted in our hospital with seizures. Patients with term pregnancies made up 34.88% of the total patients while 65.11% patients were preterm. The most common signs and symptoms seen in these patients were Headache (92%), Nausea and vomiting (90%), Epigastric pain (32%), anasarca (23%) and sudden blindness (6%). Out of 43 patients normal vaginal delivery took place in 22 (51.16%) and LSCS was done in 21 (48.83%) of the patients. The most common indication of LSCS in patients with eclampsia was fetal distress (47.61%) followed by unfavourable cervix (28.57%), failure of induction (14.28%) and contracted pelvis (9.52%). The most common complications seen in patients with eclampsia included Respiratory complications like aspiration pneumonia, pleural effusion and pulmonary oedema, which were seen in 11 (25.58%) patients followed by fever (23.25%) and haematuria (23.25%). The least common complications encountered were cardiomyopathy and cerebrovascular accidents which were seen in 2 patients (4.65%) each. Serious complications like disseminated intravascular coagulopathy, renal failure and deranged hepatic functions were seen in 16.27%, 6.97% and 13.95% respectively. convulsions to delivery interval was found to be a significant determinant of outcome and complications were found to be more common if this period exceeded more t...

Eclampsia: a retrospective study in a tertiary care centre

“…6.4% of patients had DIC which is similar to study by Agrawal M et al showed 6.97 % of DIC in their study. 13 Incidence of Hellp syndrome was 17.7% in our study which is similar to study by Kumari S et al from Andhra Pradesh who reported 18% of Hellp syndrome in their study.…”

Feto-Maternal Outcome of Pregnancy Complicated with Preeclampsia

“…It has been observed that the newborns delivered to females diagnosed with eclampsia, 46.5% were small for gestational age while 25.6% had intrauterine death and 34.88% had neonatal mortality. The overall perinatal mortality was 60.5% [17].…”

Efficacy of Magnesium Sulphate on Maternal Morbidity and Mortality in Eclampsia

“…The high perinatal mortality was mostly due to prematurity, which was also supported by other studies conducted in Lahore, Faisalabad, India and Africa 2 . Such neonates are prone to develop bronchopulmonary dysplasia, intra cranial hemorrhage, sepsis and respiratory distress secondary to surfactant defiency 15 . Long term follow up for these babies is required to look for sequel of prematurity [16][17][18][19][20] .…”