IntroductionEclampsia continues to be a major cause of maternal and perinatal morbidity and mortality in the developing world. We evaluated the incidence and outcome of women diagnosed with eclampsia in a tertiary referral centre in eastern India.MethodsThe prospective randomized study was carried out in the department of Obstetrics & Gynecology, MKCG Medical College and Hospital, Berhampur, Orissa, India, a tertiary level Government referral centre for whole of Southern Orissa, over a 2 year period. The incidence, demographics of women with eclampsia and response to three different regimens of magnesium sulphate was studied.Results160 women presented with convulsions against a background of preeclampsia of which 2 were diagnosed with cerebral malaria and hence excluded. Out of 4925 live births during the study period, there were 158 women with eclampsia, giving an incidence of 3.2 %. Majority were unbooked 154 (97.4%) and from rural areas 133 (84.2%). Antepartum eclampsia occurred in 21(13.3%) patients; antepartum / intrapartum eclampsia in 108(68.3%) while postpartum eclampsia occurred in 29 patients (18.4%). Primigravidas accounted for 105/129 cases with antepartum & intrapartum eclampsia while primiparas accounted for 25/29 cases with postpartum eclampsia. The all cause maternal mortality in the study period was 67, of which a total of 7 women died due to eclampsia, giving a case fatality rate of 4.4 % and maternal mortality ratio of 10.44%. Majority of the patients 75/158(47.45%) received magnesium sulphate at 4-8 hours after of onset of convulsions. 60 women received magnesium sulphate by Pritchard regimen (Group-A), while 49 each received magnesium sulphate by Zuspan regimen (Group-B) and Sibai regimen (Group-C) . There was no recurrence of convulsions in any patient after start of magnesium sulphate in both Groups A and C, whereas there was recurrence of convulsion in 1 patient in Group-B. There were a total of 50 still births and 5 neonatal deaths out of total of 167 deliveries in the 158 women with eclampsia. The maternal mortality and morbidity did not differ significantly between the three groups; neither did the perinatal mortality and morbidity.ConclusionEclampsia continues to be a major cause of both maternal and perinatal morbidity and mortality. Magnesium sulphate was equally effective in controlling seizures in the three groups.