Abstract
Objectives: To evaluate the epidemiology of eclampsia, to assess maternal and perinatal prognosis and management. Material and method: This was a retrospective, descriptive study from January 1, 2015 to December 31, 2018. Included were all women received in the emergency department of our health facility for generalized seizures and/or disturbances of consciousness, occurring between the 20th Week of Amenorrhea (WA) and the 6th week of postpartum on a field of hypertension. The sources of the data consisted of antenatal consultation cards, delivery records, hospital records, operating theater and resuscitation records. The variables studied were sociodemographic characteristics, the course of pregnancy, childbirth and neonatal parameters. Data were captured and analyzed using SPSS 11.0 software. Results: The study focused on 190 cases with a prevalence of 3.5%. The average age of the patients was 20 years with extremes of 14 and 40 years. The average parity was 4.1 deliveries with extremes of 1 and 7. Nearly three-quarters of the patients (74.7%) of the patients were primiparous. Almost all the patients were evacuated. More than half of the seizures (53.1%) were recorded before work and more than one out of two patients had two seizures. Caesarean section was the mode of delivery in more than one out of two patients (56.8%). Maternal complications were marked by renal failure (23 cases), the HELLP syndrome (72 cases), and the retro placental hematoma (83 cases). The fetal impact was marked by prematurity in 90% of cases and 17 cases of fetal death in-utero. Nineteen maternal deaths were recorded while early neonatal mortality was 437 per 1000 live births. The average hospital stay of the survivors was 6.2 days. Conclusion: Eclampsia is still common in our regions. It occurs preferentially in young primiparas with hypertension and/or proteinuria on a poorly followed pregnancy. Magnesium sulphate and cesarean section can improve the maternal and fetal prognosis. Prevention necessarily means quality prenatal care.
Highlights
Eclampsia is one of the most serious complications of pre-eclampsia
Included were all women received in the emergency department of our health facility for generalized seizures and/or disturbances of consciousness, occurring between the 20th Week of Amenorrhea (WA) and the 6th week of postpartum on a field of hypertension
Maternal complications were marked by renal failure (23 cases), the HELLP syndrome (72 cases), and the retro placental hematoma (83 cases)
Summary
Its occurrence during pregnancy is a serious obstetric situation and continues to be a global public health problem It is a paroxysmal gravido-puerperal accident with dominant neurological expression of unknown or abused pregnancy toxemia. It is defined by the occurrence of one or more generalized seizures and/or disorders of consciousness that can not be related to a pre-existing neurological problem [1]. Considered as one of the serious obstetric situations severely affecting the maternal and fetal prognosis, its management must be multidisciplinary fast and adequate. This management has been revolutionized by the introduction of magnesium sulphate, considered as the reference medicine in the treatment and prevention of this condition [3]. The objective of our study was to review the epidemiological peculiarities of eclampsia that could justify its constant frequency, to evaluate the management of our structure and to assess maternal and perinatal prognosis
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