Audit of Anaesthetic Management of Eclamptic Patients for Caesarean Section in the North-Eastern, Nigeria

Abstract

Background: Objectives: To determine the clinical characteristics of the obstetric patients that were complicated with eclampsia and compare it to all uncomplicated obstetrics patients (non-eclampsia) that had caesarean sections, determine the technique of anaesthesia and the anaesthetic management of the eclamptic patients in our centres. Materials and Methods: This was a retrospective case-control multi-centered study of eclamptic patients that had caesarean sections under anaesthesia in the University of Maiduguri Teaching Hospital, Maiduguri, Borno State and Federal Teaching Hospital, Gombe, Gombe State North-eastern Nigeria over four year period from January, 2011 to December, 2014. Results: A total of two hundred and seventy three (273) eclamptic patients made up 158(57.88%) and 115(42.12%) from University of Maiduguri Teaching Hospital, Maiduguri and Federal Teaching Hospital, Gombe respectively that had caesarean sections under various types of anaesthesia during the study period, which represents 17.42% of total caesarean sections (1,567 patients) and 1.87% of all deliveries (14,611 patients) during the 4-year period. Most of the eclamptic patients had GA (87.18%). The case fatality rate for eclampsia managed in ICU was 14.65%.However; the overall case fatality for eclampsia was 18.31%. Conclusion: The commonest anaesthesia employed for eclamptics was general anaesthesia, this was because most of the patients that presented to our centres were either unconscious or had late presentation. We therefore, recommend regular public enlightenment on eclampsia in our environment and also to encourage a team work among the team members.