Postpartum Eclampsia Research Articles

The Effect of Intrathecal Anesthesia during Emergency Caesarean Section for Severe Preeclampsia and Eclampsia Patients in a Tertiary Care Hospital

Background: Severe preeclampsia and eclampsia are common in Bangladesh and are one of the leading cause of perinatal morbidity and mortality. The aim of the study is to observe the effect and hazards of intrathecal anesthesia for the mangement of caesarean section for severe pre-eclampsia and eclampsia patients. Management of these patients is very much important for the strenuous obstetrician and anesthesiologist both. Materials and Methods: This retrospective observational study was conducted in the Department of Anesthesiology and ICU of the IAHS (Institute of Applied Health Sciences) Chattogram from January 2022 to December 2022. Total 50 ASA grade 1 or 11, aged between 18-40 years, need urgent LSCS of 1-2 hours duration cases were selected purposively for intrathecal anesthesia. Patients with known cardiovascular and pulmonary diseases, fetal distress, severe maternal distress, uncontrolled DM, presence of any contraindication, patient’s refusal for SAB, septicemia, BP>170/120 mmhg, altered coagulation profile, APH, IUD were excluded from this study. Results: Among the study subjects, 30(59.68%) cases were primigravida patients- out of which five had severe pre eclampsia and 25 had eclampsia. Intraoperative shivering was observed in 18(29.03%) cases, postoperative shivering was observed in 16(25.80%) cases. Acute renal failure was found in 3(6%) cases, HELLP syndrome 10%, DIC 8%, abruption placentae 14%, pulmonary edema 4%, septicemia 16%, PPH 12% and postpartum eclampsia 22% cases. Apgar score <7 at 5 minutes in severe PET was observed in 04(6.45%) cases and eclampsia in 07 (14.51%) cases. Among them 10(20.96%) were eclamptic and 02(4.83%) had PET. p value was found 0.000 which is very highly significant. Conclusion: The outcome results of intrathecal anesthesia is better than general anesthesia. IAHS Medical Journal Volume 6(2) December 2023; 58-63

Posterior Reversible Encephalopathy Syndrome presenting in late postpartum eclampsia challenging differential diagnosis

Posterior Reversible Encephalopathy Syndrome presenting in late postpartum eclampsia challenging differential diagnosis

A case of delayed postpartum eclampsia

A case of delayed postpartum eclampsia

Effect of feeding time on womens satisfaction after caesarean section a randomized control study.

Trail design A quazi randomizedd controlled trial Methods Particpaints A total of 226 parous women with singleton vaginal delivery at term pregnancy 37 to 42 weeks of gestation with cephalic presentation. Study participants who had undergone the use of tocolytics drugs for delivery, or caesarian section performed under general anaesthesia were excluded from the study. Moreover, participants with intra-operative complications bowel injury, bowel adhesions, post-partum haemorrhage and anaesthetic complications and postoperative complications postpartum haemorrhage, shock, fever, eclampsia, and use of MgSo4 were excluded from the study. The participants with pre-existing medical conditions like hypertension, diabetes and gastrointestinal diseases were screened off and removed from the study. Additionally, obstructed labour and the use of butrophanone as labour analgesia or postoperative analgesia were excluded. Intervention The study participants were divided into two groups based on the intervention considered. After the participants were selected as per inclusion criteria, an informed consent was taken from all the respondents. The early feeding group was allowed for intake of food after 6 hours of delivery starting with liquid diet followed by solid diet. Similarly delayed feeding group was allowed for intake of food after complete reversal of anaesthesia i.e. 12 hours of delivery starting with liquid diet followed by solid diet.

Faktor-Faktor yang Berhubungan dengan Kejadian Partus Lama pada Ibu Bersalin di RSUD Djoelham Binjai Tahun 2023

The maternal mortality rate (MMR) in the world based on data from the World Health Organization, according to the World Health Organization (WHO), in 2016 reached 289,000 people, divided into several countries, including the United States reaching 9,300 people, North Africa 179,000 people and Southeast Asia 16,000 soul. Approximately 80% of maternal deaths are the result of increased complications during pregnancy, childbirth and after delivery. Causes of maternal death include postpartum hemorrhage, eclampsia, prolonged labor and sepsis. One of the causes of maternal death is prolonged labor with an average number in the world of 8% and in Indonesia it is 9%. The general aim of this research is to determine the factors associated with the incidence of prolonged labor in women giving birth at the Djoelham Binjai Regional Hospital in 2023. Prolonged labor is a situation where the latent phase occurs for more than 8 hours or labor lasts more than 12 hours with the baby not yet being born. On a partograph, labor that is not progressing is indicated by cervical dilatation above the alert line (right side) in the active phase. The pathophysiology of prolonged labor is closely related to the concept of functional stages of labor which explains the physiological goals of labor. There are three functional stages of labor, namely the preparatory division, the opening/dilatation stage and the pelvic division. This research uses a quantitative type of research using retrospective research. The design of this research was carried out using a cross sectional approach. The sample in the study was women giving birth who experienced a long labor at Djoelham Binjai Regional Hospital in 2023. The proportion of respondents who had a long labor due to a weak vagina < 20' was 12 (40%), respondents who had a long labor due to CPD with In the No CPD category, there were 13 (43.3%) respondents who did not give birth for a long time due to their weight, with the weight category > 4000 grams being 12 (40%). The results (p value = 0.030 < 0.05) which means that this research shows that there is a significant relationship between His, CPD and Baby's Weight with Long Parturition at Djoelham Binjai Regional Hospital. The strength and weakness of the His during the birth process greatly influences the speed or Length of labor It is hoped that respondents will be more active in checking their pregnancies to avoid prolonged labor by health workers either at posyandu or other health service places. Keywords: Partus Lama, Persalinan

Posterior reversible encephalopathy syndrome in a patient with late postpartum eclampsia.

Posterior reversible encephalopathy syndrome (PRES) is a rare complication commonly associated with headache and acute changes in blood pressure that results from a variety of causes, culminating in vasogenic cerebral edema in the occipital and parietal lobes of the brain. We report here a woman who suffered from headache, generalized tonic-clonic seizures, and cortical blindness in the late postpartum period. Posterior reversible encephalopathy syndrome. The patient was treated with amlodipine besylate tablets for hypertension, dehydration with mannitol and glycerin fructose, and antispasmodic treatment with sodium valproate and oxcarbazepine. On day 2, the patient became conscious, headache and vision improved. One week later, symptoms and signs disappeared, blood pressure returned to normal, and brain MRI lesions disappeared in re-examination. Eclampsia associated with PRES is reversible in most cases, but it is a serious and potentially life-threatening obstetric emergency. If adequate treatment is provided in a timely manner, most women will make a full recovery. Attention needs to be paid to timely and adequate treatment, as well as appropriate follow-up and support for patients with PRES.

Successful management of postpartum eclampsia in a queen

Successful management of postpartum eclampsia in a queen

Maternal and Perinatal Outcome in Patients With Eclampsia: A Study Done at a Tertiary Care Centre.

Background One of the leading causes contributing to morbidity and mortality globally is attributed to eclampsia. Hence, it is vital to comprehensively review each female having eclampsia and to evaluate the factors that govern the outcomes in females with eclampsia. Aim To decode the fetal and maternal outcomes in subjects having eclampsia and to evaluate various factors that govern the outcomes. Methods This retrospective cohort and epidemiological study commenced at the Department of Obstetrics and Gynaecology,Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, in January 2016 till April 2017, and included females that either developed eclampsia in hospital stay duration or presented with pre-existing eclampsia. In included females, various fetal and maternal parameters were assessed along with the outcome of pregnancy. The institutional data records and the database were also used to determine the prevalence and incidence of eclampsia. Baseline maternal parameters were recorded from the already-existing institute data. These included the gestational age (in years), socioeconomic status, educational attainment, parity, gravidity, and the number of weeks of gestation present at the time of delivery. Antenatal care data assessed were blood pressure recordings, any proteinuria documented in the data, and the number of antenatal visits by the subjects. Statistical analysis was performed to assess both parameters. Results In the current investigation, there were 0.34% eclampsia cases among females visiting the institution for deliveries. Incidences of stillbirth were seen in 19.04% and 8% of study participants, respectively. We found 9.52% (n=4) of female infants to have perished from eclampsia. Preterm births, a delayed start to the treatment, and insufficient care were all linked to poor foetal and mother outcomes. The longer the period between the beginning of a fit and delivery, the greater the likelihood of unfavourable results.Seizure onset before or after birth, parity, or subject age had no impact on mother or foetal health.The p-value for statistical significance was kept at 0.05. Conclusion Most of the research participant women, had intrapartum eclampsia, postpartum eclampsia, and antepartum eclampsia, based on the time of the convulsions in relation to the labor. It was highlighted that there was no conclusive evidence linking the date of the fit's beginning to unfavourable results or an elevated risk of complications. Neonatal mortality and stillbirth were observed with vaginal delivery in eclampsia cases. Outcomes in eclampsia can be improved byearly treatment initiation, timely and appropriate referral, early disease recognition, and appropriate antenatal care.

Postpartum Eclampsia Management with Lytic Cocktail Solutions in Rural and Semirural Health Care (with Limited Resources) Services in Eritrea

Postpartum Eclampsia Management with Lytic Cocktail Solutions in Rural and Semirural Health Care (with Limited Resources) Services in Eritrea

Subcapsular Hematoma of the Liver and Right Renal Hematoma Complicating Eclampsia: A Case Report

Subcapsular haematoma of the liver (SCLH) is a rare and serious complication in pre-eclampsia, occurring in a relatively stereotyped but non-specific clinical picture, which often leads to a delay in diagnosis. Its secondary rupture is one of the most serious obstetrical complications with an estimated maternal mortality of 50-75% and fetal mortality of 60-80%. We reported a case of a 37-year-old woman presented to the emergency department with postpartum eclampsia, which was revealed by generalized tonic-clonic seizures. On the second day of hospitalization, the patient developed persistent epigastric pain that was resistant to analgesic treatment. Bedside abdominal ultrasound showed a moderate amount of peritoneal effusion, and a complement CT scan revealed a subcapsular hematoma of liver with moderate hemoperitoneum and right renal hematoma. The therapeutic decision was to continue close clinical and laboratory monitoring twice daily. Improvement was noted in laboratory tests on the fourth day of hospitalization, with normalization on the twelfth day.

Estimating maternal mortality and identifying causes of maternal deaths in Jammu and Kashmir: a two-year epidemiological study

Background: An accurate estimate of the maternal mortality ratio and its underlying causes is crucial for the effective planning of maternal health services. The aim of the study was to estimate the maternal mortality ratio (MMR) and identify causes of maternal deaths in Jammu and Kashmir. A subnational geographical area in India. Methods: The study included maternal deaths from April 2020 to March 2022 among residents of Jammu and Kashmir. We enumerated all maternal deaths and recorded their socio-clinical parameters from interviews with family members. The cause of death was inferred from the medical records and verbal autopsy. Live births data for the corresponding period was obtained from the routine health management information system. We calculated the maternal mortality ratio using a standard formula. Results: A total of 185 maternal deaths and 3.97 lakh live births were recorded over the two-year study period. It translated into an MMR of 47 per lakh live births, exhibiting noteworthy variability between districts. Postpartum haemorrhage (PPH) and hypertensive disorders of pregnancy accounted for a substantial proportion of maternal deaths, representing 44.3% (82/185) of cases. Sepsis and other obstetric complications were identified as the cause of death in 15.7% (29/185) and 19.5% (36/185) of maternal deaths, respectively. Furthermore, the majority of maternal deaths occurred among women between 25-30 years of age. Approximately two-thirds of maternal deaths occurred during the post-partum period. Conclusions: In summary, our study reveals that the maternal mortality rate (MMR) in Jammu and Kashmir falls below the sustainable development goal target, albeit with marked inter-district variability pointing to disparities in healthcare delivery. We recommend expanding the coverage of evidence-based interventions aimed at reducing the incidence of postpartum haemorrhage, eclampsia, and other obstetric complications to improve maternal health outcomes.

Presentation And Outcome of Eclampsia in a Tertiary Centre

Aim & Objective: Demographic datas like the patients age, gestational age, admission BP, blood and urine investigation, neuroimaging, Management, mode of delivery, neonatal and maternal outcomes were analysed in patients presenting with eclampsia in a tertiary care centre. Introduction: The onset of convulsions in a woman with pre eclampsia that cannot be attributed to other causes is termed eclampsia. Eclampsia is a major cause of maternal and neonatal morbidity and mortality. Magnesium sulfate is the drug of choice for reducing the rate of eclampsia and also to prevent recurrent convulsions in eclampsia. Materials and Methods: The study was conducted retrospectively on cases presenting with eclampsia in the OBG department, Government Rajaji Hospital for a period of 6 months from July 2019 to December 2019. Results: During the 6 month study period, total 26 cases of eclampsia was reported out of 5843 deliveries (0.4%). Total 657 cases of hypertensive disorders of pregnancy (11.2%) was reported out of which 65 cases were severe pre-eclampsia (9.8%). 65% (11) of eclampsia presented as Antepartum eclampsia, 30.7%(11) cases presented as postpartum eclampsia, 3.8%(1) case as intrapartum eclampsia. One case presented as both antepartum and postpartum eclampsia. No case of maternal mortality was reported during the study period. Conclusion: Early detection of cases of pre-eclampsia and imminent eclampsia, proper evaluation and treatment with anti-hypertensives and Magnesium sulphate will reduce the occurrence of eclampsia. Multidisciplinary approach in a tertiary care centre can reduce the maternal mortality and morbidity. Proper knowledge of management of eclampsia can reduce the mortality. IV labetalol and its careful use is mandatory. Perinatal mortality is high mainly because of prematurity.

Oral Labetalol in Comparison with Methyldopa in Treatment of Gestational Hypertension as a First Line Drug

Background: Defining hypertension in pregnancy, it is taken as systolic blood pressure of 140 or more and diastolic blood pressure of 90mg or more. Presence of proteinurea differentiates chronic hypertension and gestational hypertension from pre eclampsia .Prevalence and incidence of hypertension in pregnancy along with its complications like end-organ damage, preeclampsia, eclampsia, and postpartum eclampsia are increasing. Gestational hypertension and its sequels are major causes of fetal and maternal morbidity and mortality and affect almost 8% of pregnancies. Labetalol and methyldopa were effective in reducing systolic and diastolic BP significantly but labetalol was found to control BP more rapidly and efficiently. Safety profile of both drugs was similar. The rationale of this study is Labetalol is more effective in comparison with Methyldopa in pregnancy induced hypertensive females in terms of control of blood pressure within 48hours of drug intake, in pregnant patients between POG of 28 to 32 weeks. Design: Randomized control trial. Place and Duration of Study: Department of Gynaecology Unit 2 Bahawal Victoria Hospital, Bahawalpur from 1st January 2022 to 31st December 2022. Methodology: One hundred 100 patients having gestational hypertension between periods of gestation from 28to 32 weeks were enrolled. They were divided into 2 groups; group A treated with labetalol and B treated with methyldopa respectively. Results: Statistical no significant difference in systolic and diastolic blood pressure was observed before starting treatment in both groups but a significant fall in diastolic blood pressure was observed in group A after 48 hrs of initiation of treatment i.e., with labetalol (P = 0.007) Conclusion: Both labetalol and methyldopa reduce blood pressure in women with gestational hypertension but labetalol is more effective than methyldopa as proved by our study. Keywords: Gestational hypertension, Diastolic blood pressure, Labetalol, Methyldopa

Eclampsia with hypothyroidism complicated with posterior reversible encephalopathy syndrome–a case report

BackgroundPosterior reversible encephalopathy syndrome (PRES) is a rare neurological disorder with complex physiopathological mechanisms that have not been fully understood. Early identification is of great prognostic significance, of which the symptoms and radiological abnormalities can be completely reversed. If the diagnosis and treatment are delayed, ischemia and massive infarction may be developed in some patients. Posterior reversible encephalopathy syndrome (PRES) has been reported mainly in association with postpartum eclampsia, which have been rarely reported, while the association with hypothyroidism has not been reported at home or abroad.Case presentationHere we report on a pregnant 29-year-old with multipara and a chief complication of hypothyroidism. She presented in the emergency department with frequent attacks of severe headache symptoms resulting from reversible cerebral vasoconstriction syndrome (RCVS), accompanied with prenatal eclampsia. PRES was determined by radiological examination.ConclusionTo the best of our knowledge, this is the first case of PRES complicated by hypothyroidism and prepartum eclampsia.Clinicians should be alert for the co-occurence of eclampsia, PRES, and RCVS when patients have convulsions after a typical throbbing headache. Moreover, regular monitoring of thyroid function during pregnancy should also occupy certain special attention.

The Efficacy of the Spinal Anesthesia during Emergency Cesarean Section for Severe Preeclampsia and Eclampsia Patients

Background: The most common causes of prenatal morbidity and death in Bangladesh are eclampsia and severe preeclampsia or toxemia (PET). Obstetricians and anesthesiologists have complex challenges while dealing with this condition. Despite the improved result of spinal anesthesia over general anesthesia, general anesthesia is still routinely used for emergency LUCS in underdeveloped nations. More and more people in industrialized nations, such as the United Kingdom and the United States, recognize spinal anesthesia for its safety. Objective: In this study our main aim is to evaluate the efficacy of the Spinal Anesthesia during Emergency Cesarean Section for Severe Preeclampsia and Eclampsia Patients. Method: This cross-sectional study was carried out at tertiary medical hospital from January 2020 to January 2021. Total 200 cases of severe PET (n=110) and eclampsia (n=100) patients were selected by subarachnoid block for emergency LUCS. Each patient was given magsulph as prophylactic or maintenance dose and judiciously preloaded by crystalloid fluid. Results: Most of the patients belong to 31-40 years age group, 55% and 95.8% cases were multigravida. In severe PET group, intraoperative hypotension was observed in 32% cases and postoperative period hypotension was observed in 8% cases. Whereas preeclampsia group, intraoperative hypotension was observed in 31% cases and postoperative period hypotension was observed in 9% cases. In addition, maternal morbidity where acute renal failure seen in 5%, syndrome 7%, DIC 7%, abruptio placentae 12%, pulmonary edema 4%, septicemia 13%, PPH 10% and postpartum eclampsia 15%.In severe PET group, 21% cases transferred to eclampsia ward, followed by 9% shifted to ICU, 1% case was expired. Whereas, in preeclampsia group 20% cases transferred to eclampsia ward, followed by 8% shifted to ICU, 2% case was expired. In eclamptic group 7% cases were transferred to NCU, whereas 8% had PET. Neonatal mortality was observed in 3% cases. p value was found 0.000 which is very highly significant. Conclusion: With close monitoring of perioperative events, spinal anesthesia may be used as a safe alternative technique to GA or epidural in severe preeclampsia and eclampsia, even in cases of altered consciousness or restlessness in the presence of an expert and skilled anesthesiologist, reducing perioperative maternal and neonatal morbidity and mortality.

MATERNAL NEAR MISS: AN INDIAN TERTIARY CARE CENTRE AUDIT

ACKGROUND: Despite advances in medical sciences and increased awareness of measures for safe child birth, unacceptably high maternal morbidity and mortality continues in developing countries like India. Ours being a tertiary care centre, draws a lot number of high risk pregnancies and referrals. By auditing the near miss cases2 i.e., a critically ill pregnant or recently delivered woman who was on the verge of death but survived a problem during pregnancy, childbirth, or within 42 days of the pregnancy's termination, we aim to identify the causes, factors leading to near miss2 and the management given to near miss2 and maternal deaths. The AIMS AND OBJECTIVES: present study aims to determine the magnitude, as well as to identify the pattern of Maternal Near Miss2 (MNM), at Siddhartha Medical College, Vijayawada, during the study period of two years. To anal OBJECTIVES: yse 1)Adverse events leading to a maternal near-miss2, 2) Disorders underlying these cases, 3)Sociodemographic factors and 4)Contributing factors A hospital based retros METHODOLOGY: pective observational study to assess the frequency and nature of maternal near miss2 events among the obstetric cases managed at Siddhartha Medical College, Vijayawada over a period of two years. The followi RESULTS: ng are the major causes identied leading to maternal near miss2 during our study Severe Eclampsia 17%, Post-partum Haemorrhage 17%, Pulmonary Edema due to severe pre eclampsia3 9%, Antepartum Eclampsia 9%, HELLP 9%, Ruptured ectopic pregnancy 7%, Cardiac failure 7%, Postpartum Eclampsia 7%, Imminent Eclampsia 4%, Abruption 4%, Rupture uterus 2%. In our study Maternal near miss2 ratio incidence: 0.0254, Severe maternal outcomes ratio : 3, Maternal near miss2 to mortality ratio: 0.433 CONCLUSION: We observed in majority of the cases level 1 and level 2 delays in reporting to our institution

Posterior reversible encephalopathy syndrome (PRES): A case report

Patients with preeclampsia or eclampsia may be associated with hypertension, seizures and other neurologic symptoms and deficits. A young female patient presented with a neurological and visual disturbance which included variable symptoms like visual disturbances, headache, seizures and altered consciousness or mental status with a history of postpartum eclampsia after an uneventful LUCS. She also gave a history of a two-bag blood transfusion one month ago. A neurological and ophthalmic evaluation was performed. Detailed history taking and clinical evaluation followed by an imaging study, potentially magnetic resonance imaging (MRI), helped to confirm the diagnosis of Posterior reversible encephalopathy syndrome (PRES). PRES is a clinico-neuroradiological disorder of neurotoxicity that typically involves headache, mental confusion, seizures, and occasionally loss of vision. The exact pathophysiology of PRES is still unclear and has not been thoroughly explained. Hypertension and endothelial cell injury may be pathognomic. Prompt management may help to recover early.

Carbetocin: The New Preferred Treatment For Partum Hemorrhage

Background: Postpartum hemorrhage defined as the condition blood loss more than 500 mL from the female genital tract after vaginal delivery of the fetus (or >1000 mL after cesarean section). Case Presentation: Mrs. FA 31 year’s old G2P1A0 40 weeks age gestation preeclampsia with main complaints dyspnea and swollen legs. Physical examination showed decreased saturation, increase blood pressure, rhonci, and pitting edema of the pedal. Cardiomegaly with pulmonary edema on x-ray, elevated liver enzymes, LEA value +3, perfectly compensated respiratory alkalosis and electrolyte imbalance on laboratory test. Four-hour post C-section she got postpartum hemorrhagic and given oxytocin due to maximizing use of uterotonic agent, MgSO4 stopped and patient reported with postpartum eclampsia. Conclusion: Many studies discus other drugs to replace oxytocin, considering side effects to prevent postpartum hemorrhage. Carbetocin could be one potent agent of uterotonic agents with lower side effect.

Postpartum Acute Intestinal Intussusception: A Case Report with Literature Review of a “Pediatric Pathology in an Adult”

Introduction: Intestinal intussusception is defined as the penetration of a proximal segment of the intestine into a distal segment, leading to intestinal obstruction. It is a common cause of small bowel obstruction in children. This pathology is rare in adults and represents only 1% of all cases of intestinal obstruction. We report a case of ileoileal intestinal intussusception in a 26-years-old adult woman, complicating postpartum eclampsia. Case Presentation: This was a 26-years patient being treated for eclampsia associated with HELLP syndrome and complicated with acute kidney injury. The diagnosis of intussusception was made based on a clinical bowel obstruction syndrome and confirmed with ultrasounography. The management consisted of laparotomy with surgical resection of the invaginated bowel segment. Conclusion: Intestinal intussusception is mainly a childhood pathology which may exceptionally occur in adults. The degree of bowel and hence abdominal distension caused by intestinal obstruction justifies surgical exploration, with subsequent resection of invaginated segment as a therapeutic intervention.

The Efficacy of the Spinal Anesthesia during Emergency Cesarean Section for Severe Preeclampsia and Eclampsia Patients

Background: In Bangladesh, severe preeclamptic toxemia and eclampsia are life-threatening conditions in pregnancy that are the leading cause of perinatal maternal and neonatal mortality and morbidity. Objective: in this study our main aim is to evaluate the efficacy of the Spinal Anesthesia during Emergency Cesarean Section for Severe Preeclampsia and Eclampsia Patients. Method: This cross sectional study was carried out at tertiary medical hospital from January 2021 to January 2022. Total 200 cases of severe PET (n=110) and eclampsia (n=100) patients were selected by subarachnoid block for emergency LUCS. Each patient was given magsulph as prophylactic or maintenance dose and judiciously preloaded by crystalloid fluid. Results: Most of the patients belong to 31-40 years age group, 52% and 95.8% cases were multigravida. In severe PET group, intraoperative hypotension was observed in 32% cases and postoperative period hypotension was observed in 8% cases. Whereas preeclampsia group, intraoperative hypotension was observed in 31% cases and postoperative period hypotension was observed in 9% cases. In addition,maternal morbidity where acute renal failure seen in 5%, syndrome 7%, DIC 7%, abruptio placentae 12%, pulmonary edema 4%, septicemia 13%, PPH 10% and postpartum eclampsia 15%.In severe PET group, 21% cases transferred to eclampsia ward, followed by 9% shifted to ICU, 1% case was expired. Whereas, in preeclampsia group 20% cases transferred to eclampsia ward, followed by 8% shifted to ICU, 2% case was expired. In eclamptic group 7% cases were transferred to NCU, whereas 8% had PET. Neonatal mortality was observed in 3% cases. p value was found 0.000 which is very highly significant. Conclusion: With close monitoring of perioperative events, spinal anesthesia may be used as a safe alternative technique to GA or epidural in severe preeclampsia and eclampsia, even in cases of altered consciousness or restlessness in the presence of an expert and skilled anesthesiologist, reducing perioperative maternal and neonatal morbidity and mortality