Spectrum of Neurological Complications in Eclampsia in a Tertiary Care Hospital in India.

Abstract

Preeclampsia or eclampsia is associated with significant maternal morbidity and mortality, and neurological complications are varied. This prospective observational study sought to collect data and push for early aggressive diagnostic evaluation for neurological complications in eclamptic women. The study was conducted in Lady Hardinge Medical College and associated Shrimati Sucheta Kriplani Hospital in New Dehli, India from July 2014 to July 2016. All women who underwent Caesarean delivery (CD) and had preeclampsia were identified, and eclamptic women who had CD and required critical care in the ICU were further followed up. A total of 741 women (of the 5564 women with CDs) had preeclampsia. Of the 63 women in whom eclampsia developed, 32 required ICU admission. The incidence of neurological complications associated with eclampsia was 20.63%, and it was 40.62% among patients admitted to the ICU. In the patients who developed neurological complications, the mortality rate was 46.15%. Neurological complications are not uncommon in eclampsia, and a high index of clinical suspicion is essential for early detection and proper management of these patients. All patients with eclampsia and neurological complications had raised systolic blood pressure, but not all had thrombocytopenia. Despite control of seizure with MgSO4, the incidence of neurological complications remains high.