A Review Of Eclampsia At The Lagos University Teaching Hospital (LUTH), Lagos, Nigeria: Have We Improved?

Abstract

A total of 12,234 patients were treated in the Lagos University Teaching Hospital (LUTH) for various obstetric conditions between January 1, 1996 and December 31, 2005. Of these, 165 (1.35%) were eclamptics. 148 (89.7%) of these were pre-delivery eclamptics and 17 (10.3%) were post-delivery eclamptics. Unbooked eclamptics remained a dominant group comprising 149 (90.3%) of all eclamptics. Mean maternal age was 26.59±0.44 years. Most of these patients were of low parity; primiparae constituting 76.8% and multiparae 23.2%. Mean gestational amenorrhoea at onset of eclampsia being 34.64±0.44 weeks. There were 22 maternal deaths due to eclampsia and its complications with a maternal mortality rate of 133.3 per 1000 eclamptics. The commonest causes of maternal deaths were septicaemia (13.64%), acute renal failure (9.09%) and respiratory failure (9.09%). There were 54 perinatal deaths, with a perinatal mortality rate of 346.2 per 1000. A comparison of the data obtained from this recent decade (1996 - 2005) to those of the previous three decades (1967 - 1976, 1977 - 1986 and 1986 - 1995) showed that there had been a progressive decline in the number of eclamptics managed in LUTH in the last three decades (572 eclamptics in 1977 - 1986, 299 eclamptics in 1986 - 1995, and 165 in 1996 - 2005). This study also showed a rise in the mean caesarean section rate for pre- delivery eclamptics and all eclamptics (55.41% and 49.70% respectively) compared to findings in the previous decades. There was a significant increase in the maternal mortality and perinatal mortality rates in recent decade. There was a decline in post mortem rate (40.9% in recent decade compared with 60% in previous decades).