Abstract
BackgroundEclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital.MethodsThis was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5.ResultsDuring the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0).ConclusionThere is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.
Highlights
Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women
Eclampsia is among the most common causes of maternal and perinatal mortality and morbidities. It refers to the occurrence of one or more seizures and/or unexplained coma before, during and after birth irrespective of one’s history of hypertensive disorders, including preeclampsia [1,2,3]
Eclampsia is considered as complication of severe preeclampsia because the majority of affected pregnant women have hypertensive disorders, and 16% of them have normal blood pressures [3]
Summary
Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Eclampsia is among the most common causes of maternal and perinatal mortality and morbidities. It refers to the occurrence of one or more seizures and/or unexplained coma before, during and after birth irrespective of one’s history of hypertensive disorders, including preeclampsia [1,2,3]. In lowand middle-income countries (LMICs), sub-Saharan Africa included nearly 17.9% of women with eclampsia and other hypertensive disorder-related complications during pregnancy (stroke, coagulopathies).
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