PREGNANCY OUTCOME IN ECLAMPSIA INFLUENCED BY THE MODE OF DELIVERY

Abstract

BACKGROUND: To study the association between mode of delivery and maternal and perinatal outcome in eclampsia. METHODS: This was a tertiary care based prospective observational study conducted in the Department of Obstetrics and Gynecology, between the study period October 2018-September 2020.Atotal 165 cases of eclampsia, with >32 weeks gestation, reassuring foetal heart and no other complications were included in the study. They were divided into two groups; Group I undergoing planned vaginal delivery, Group II undergoing early caesarean delivery, maternal and perinatal outcome was analysed and compared between the two groups. RESULT: Maximum number 75 (45.45%) of the study participants were in between 37.1-40 weeks of gestation at the time of admission, Majority of the study participants 125 (75.76%) had an unfavorable cervix i.e., Bishop's score ≤5 on initial assessment at the time of admission. There was no maternal mortality in our study. There was no statistically signicant difference in maternal morbidity. The still births and perinatal deaths were seen to be higher in the planned vaginal delivery group (1 still birth and 3 perinatal deaths). Perinatal morbidity was affected by mode of delivery of delivery, gestational age, BISHOP's score, number of convulsions at time of induction and convulsion delivery interval. CONCLUSIONS:The maternal outcome was seen to be comparable between both the groups and there was no statistically signicant difference between them, the perinatal outcome was better in the early caesarean delivery group as compared to the planned vaginal delivery group, specically in those with an unfavorable cervix and away from term. Early caesarean section to expedite delivery cannot be recommended for all cases of ante partum eclampsia.