Maternal and Fetal Outcome of Eclamptic Patients in a Tertiary Hospital

Abstract

Objective: To study on clinical profile & maternal - fetal outcome of eclamptic patient.Methods: A prospective cross sectional study was done in the department of Obstetrics & Gynaecology in Chittagong Medical College and Hospital from January to December 2010. All patients with eclampsia were included in the study, it was 416. Patients came with convulsion other than eclampsia e.g. epilepsy, malaria, septicemia, meningitis, encephalitis, cerebral haemorrage, high fever, hepatic coma were excluded.Main outcome measures: Incidence of eclampsia, sociodemographic status, ante natal care, time interval between attack and admission, level of consciousness was assessed by AVPU(Alert, response to voice, response to pain stimuli, Unconsciousness) score, types of eclampsia patients (antepartum,intrapartum,postpartum), number of convulsion, gestational age distribution of the patients, mode of delivery , maternal and fetal outcome.Results: Total number of deliveries during this period was 13,635. The incidence of eclampsia in this study was 3.05 %. Among 416 patients with eclampsia most of the patients were between 20-25 years (77%), a large number were primi para (72.5%), most of them comes from rural area (76%), most of them belongs to poor socioeconomic condition (72%), 49% patients were illiterate, 60 % patients had no antenatal check up, 52 % patients came after 6 hours of beginning of convulsion, 18 patients (4%) were unconscious, most of the patients had antepartum eclampsia (64%) , number of convulsion was between 5-9 in about 58% case , 63% were delivered by LSCS, 23% mother showed complications of eclampsia, of them pulmonary oedema (7.45%) and renal failure(6.49%) were common, 35 (8%) mothers were died. Among perinatal mortality 18% baby were stillbirth and 9% were early neonatal death.Conclusion: Eclampsia is still a major killer disease in Bangladesh. It is a preventable disease if preeclampsia is diagnosed by antenatal care. By giving quality antenatal care, mass awareness regarding the importance of antenatal care, emergency obstetric service in the upazilla health complex we can prevent eclampsia. Female education, employment, empowerment is urgently needed to reduce the incidence of this killer diseases. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13784 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 77-80

Maternal and perinatal outcome of eclampsia in a tertiary care centre

“…The diagnosis of eclampsia is usually associated with proteinuria (at least 1+ on dipstick). In our series 29% of patients had 4+, 33% had 3+, 26% had 2+, 9% had 1+ and 3.6% had negative which is similar to the study done by Mattar F et al 11 Cesarean section was a common mode of delivery in our series (47%) which is similar to study done by Sibai BM et al 12 Eclampsia per se is not an indication for cesarean section and mode of delivery had no significant effect on the outcome of the eclamptics as per Ibrahim A et al 13 The decision to perform cesarean section should be based on fetal gestational age, fetal condition, presence of labour , cervical Bishop score and maternal condition. Labour is usually induced with prostaglandins and early rupture of membranes and the obstetrician can monitor and await vaginal delivery once the patient is stable and convulsions are under control.…”

Study of sociodemographic profile, maternal, fetal outcome in preeclamptic and eclamptic women: a prospective study

“…Low birth weight in this study is consistent with several other studies. 25,26 It was observed in present study that 26% of subjects had still birth including (antepartum and intrapartum) which was observed in 18% of subjects in study conducted by Akhtar R et al, and 17.4% in the study conducted by Doddamani GB et al 27,28 In present study 58% of the neonates were discharged from hospital alive and 16% had early neonatal deaths which were comparable to the study conducted by Akhtar R et al 27…”

Maternal and foetal outcome of eclampsia in a referral hospital

“…This is comparable to a study by Akhtar R in Bangladesh where 60% patients had no antenatal check-up, 64% had antepartum eclampsia, 63% were delivered by LSCS. 7 The high incidence of eclampsia was due to referral of cases from peripheral hospitals. This is a referral hospital and treats cases of East Singhbhum, West Singhbhum, Sareikela-kharsawan (Jharkhand), Mayurbhanj, Sundergarh (Orissa) and Purulia, Medinipur (West Bengal).…”