Abstract
BackgroundThe incidence of eclampsia and its adverse maternal outcomes are very high in developing countries, particularly in Subsaharan African Countries. Identifying predictors for adverse maternal outcomes of eclampsia has paramount importance for helping health care providers to optimize their management outcomes. Therefore, this study aimed to assess the incidence of adverse maternal outcomes of eclampsia and its determinant factors.MethodsA retrospective follow-up study design was applied. The data were extracted from patient charts using a structured, pre-tested, questionnaire. Descriptive analyses (frequencies, means, and standard deviation) were calculated, and bi-variable and multivariable logistic regression models were used to testing the association between independent variables and an outcome variable. After the data were coded and entered into Epi-Info Version 7.2 Software, the data were analyzed using STATA Version 14 Statistical Software.ResultsThe magnitude of eclampsia was 5.36 per 1000 pregnancies (95% CI: 4.72, 6.10). The incidence of adverse maternal outcomes in eclamptic mothers was 53.7% (95% CI: 47.02, 60.24%). After adjusting for covariates maternal age 30–34, AOR 5.4 [95% CI = 1.02, 28.6]; age above 34, AOR 10.5 [95% CI = 1.3, 88.6]; gravidity 2–4, AOR 0.3 [95% CI = 0.1, 0.9]; 10 or more convulsions, AOR 4.6 [95% CI = 1.4, 14.9]; mild pyrexia, AOR 20.4 [95% CI = 3.7, 112.7]; moderate pyrexia, AOR 14.6 [95% CI = 1.7125.1]; platelet count below 50,000 cells/mm3, AOR 34.9 [95% CI = 3.6, 336.2]; platelet count between 50,000 and 99,000 cells/mm3, AOR 24.5 [95%CI = 5.4111.6]; and stillbirth of the current pregnancy, AOR 23.2 [95%CI = 2.1257.5] were strong predictors of adverse maternal outcomes in eclamptic mothers.ConclusionsThe incidence of adverse maternal outcomes of eclampsia was found to be high compared to similar studies discussed in this study. This study recommends early identification of patients with the risk factors (having many convulsions, high body temperature, low platelet count, patient age above 30 years, and 2–4 pregnancies), strengthening the referral system, and advocation of research on the area of adverse maternal outcomes and thereby encourage evidence-based medicine.
Highlights
The incidence of eclampsia and its adverse maternal outcomes are very high in developing countries, in Subsaharan African Countries
Baseline characteristics of the participants The total deliveries in the study period were 46, 803, of which 251 patients were diagnosed with eclampsia and making the magnitude of eclampsia 5.36 per 1000 pregnancies
Adverse maternal outcomes in eclamptic patients were found to be high. Determinants such as multiple episodes of convulsions, increased maternal body temperature, a decrease in platelet count, the presence of coexisting stillbirth, patient age group above 30 years, and having 2–4 number of pregnancies were independently associated with adverse maternal outcomes
Summary
The incidence of eclampsia and its adverse maternal outcomes are very high in developing countries, in Subsaharan African Countries. This study aimed to assess the incidence of adverse maternal outcomes of eclampsia and its determinant factors. The common adverse maternal outcomes are abruption placenta, disseminated intravascular coagulation (DIC), maternal shock, hemolysis elevated liver enzymes and low platelets syndrome (HELLP), acute kidney injury (AKI), respiratory distress, neurologic complications, postpartum hemorrhage (PPH), blood transfusion requirement, intensive care unit (ICU) admission, and maternal deaths [2, 6, 10,11,12,13,14,15,16,17,18,19]
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