Maternal and perinatal outcome in women with eclampsia: a retrospective study at the University of Benin Teaching Hospital

Abstract

Background: Eclampsia is a serious obstetric complication with attendant high maternal and perinatal morbidity and mortality especially in the developing countries. This study aims to assess the maternal and perinatal outcomes of eclampsia and suggest ways to improve them.Methods: This was a 5-year retrospective study (2009-2013) of cases of eclampsia managed at the University of Benin Teaching Hospital, Benin City, Nigeria. The number of cases managed was obtained from records at the emergency room, labour ward, theatre, lying-in wards and special care baby unit and case notes of patients satisfying the inclusion criteria retrieved from the medical records library.Results: The prevalence of eclampsia was 1.99% of total deliveries. It was highest in teenagers (29%), nulliparous (3.1%) and the unbooked (8.5%). Antepartum eclampsia accounted for 69.6% of the cases and a majority (74.6%) was delivered by emergency caesarean section. Eclampsia resulted in 27.78% of total maternal mortality, case fatality rate of 15.96% and eclampsia-related maternal mortality ratio of 318/100,000 deliveries. Perinatal mortality rate was 131/1000 eclamptic deliveries.Conclusions: The maternal outcome worsened with increasing blood pressure, number of convulsion episodes prior to presentation, the time interval between 1st convulsions to delivery, level of proteinuria on dip stick and reduced urine output. Vaginal delivery was associated with more early neonatal deaths and birth asphyxia. More awareness and enabling factors should be created for more women to access antenatal facilities. The government should be committed to providing emergency obstetric care facilities in our hospitals for effective management of eclampsia.

Eclampsia Managed at Nnamdi Azikiwe University Teaching Hospital (NAUTH), NNEWI, South-East Nigeria: A 5-Year Retrospective Cross-Sectional Studya

“…In this study, majority of the women were delivered through cesarean section. This is similar to the study by Okoror where the most common route of delivery was the abdominal route in eclamptic women [22]. However, in most studies across the world, caesarean section delivery has been repeatedly reported to be higher in women with eclampsia [23,24].…”

“…However, in most studies across the world, caesarean section delivery has been repeatedly reported to be higher in women with eclampsia [23,24]. The definitive treatment for pre-eclampsia/eclampsia is delivery through the safest and fastest route, which can either be via abdominal or vaginal delivery, thus following maternal stabilization, timely delivery improves outcomes [22,23]. It is therefore important to aid the provision of more comprehensive emergency obstetrics care centers with Volume 7; Issue 1 Gynecol Obstet, an open access journal ISSN: 2577-2236 adequate skilled manpower where eclampsia could be adequately managed so as to prevent mortality and morbidity associated with the condition.…”