STUDY OF MATERNAL AND PERINATAL OUTCOME IN ECLAMPSIA IN A TERTIARY CARE CENTRE

Abstract

Background: Eclampsia is a life threatening emergency that continues to be a major cause of serious maternal morbidity and is still the leading cause of maternal mortality worldwide. Objective: Analysis of all cases of Eclampsia patients to determine the incidence of eclampsia , to evaluate the clinical course, medical & obstetric management, and complications and to study the maternal & perinatal outcome. Methods: This study was a hospital based prospective observational study. We obtained the data for this study from the two hundeds case records of Eclampsia patients who admitted in the Department of Obstetrics & Gynaecology, J.L.N.M.C.H Bhagalpur and data were recorded on a predesigned proforma. All the obstetrical women with convulsions after 20 weeks pregnancy or in postpartum period were evaluated. Each case was documented with respect to age, socioeconomic status, education, occupation, gestational age, time of onset of Eclampsia, duration and frequency of seizures, mode of delivery, use of drugs (anticonvulsant and antihypertensive), maternal and perinatal outcome. Results: Out of total 200 Eclampsia patients, Antepartum Eclampsia were 141(70.5%), Intrapartum Eclampsia were 24 (12%), Postpartum Eclampsia were 35(17.50%) .Out of them, 70% were in age group of 18-25 years, 20.6% were in 26-30 years and 9.4% were above 30 years. Out of these, only 1.86% was booked and rest of them were unbooked 98.14%. Out of them 58.6% were primi, 36.8% were multipara and 4.6%were grand multipara. 69% had severe hypertension, 10% had BP < 140/90 mm of Hg. Significant proteinuria was present in 92% cases. Generalized oedema was present in 27% cases at the time of admission. There were 20 maternal deaths and morbidity consisted of pulmonary oedema in 34 (40%), Abruptio placenta in 18(21.18%), CVA in 11 (12.94%), PPH in 10 (11.76%), renal failure in 6 (7.06%), HELLP Syndrome in 5 (5.88%), and Aspiration Pneumonia in 1 (1.18%) cases. Perinatal mortality was 44.6% with majority being related to extreme prematurity. Conclusions: There is a need of proper antenatal care to prevent Eclampsia and the need for intensive monitoring of women with Eclampsia throughout the hospitalization to improve both the maternal & perinatal outcome. Keywords: Eclampsia, Maternal Mortality, Magnesium Sulphate, Perinatal outcome