Comparison of Fetomaternal Outcome Between Planned Vaginal Delivery and Planned Cesarean Section in Women with Eclampsia: Observational Study.

Abstract

The route of termination of pregnancy in eclampsia is not clearly established. This study aims to compare the fetomaternal outcome between planned vaginal delivery and planned cesarean section in women with eclampsia after 34weeks of gestation. This prospective observational study was conducted in the department of Obstetrics and Gynecology, Midnapore Medical College, West Bengal, India. 182 women with eclampsia carrying 34weeks or more gestation were allocated to either cesarean(CD) or vaginal delivery (VD) group. The primary measure of outcome was severe maternal outcome. Secondary measures of outcome were perinatal mortality and morbidity. Of the 62 women allocated in vaginal delivery (VD) group, 60 women (32.97%) had vaginal delivery and 122 (67.03%) had undergone cesarean delivery (CD). Severe maternal outcome was more common in VD group in comparison with CD group (72.5% vs 27.5%, P < 0.00001 RR 2.64 OR 6.98). Perinatal outcome in relation to Apgar score at 5min, still birth was better in CD group than VD group. Perinatal death was higher in VD group when compared with CD group (25.8%; vs. 8.33%; P = 0.002, RR 3.1 OR 3.83). There is increasing trend of delivering the eclampsia mother at > 34weeks of gestation by cesarean section instead of inducing labor and delivering vaginally. Cesarean section when chosen as method of delivery does not increase morbidity or mortality.