Maternal Outcome in Eclampsia

Background: Our objective was to study the presentation and determinants of maternal outcome . Research Methodology: A cross sectional study was designed and data was collected over six months from 1-1-03 to 30-6-03 at a tertiary care hospital, Postgraduate Medical Institute, Lady Reading Hospital Peshawar. All cases of eclampsia (n = 50) admitted to Gynae “A” unit during the study period were included in the study. The variables included, patient’s age, parity, booking status, gestational age, location at the time of first seizure, number of fits, and seizure to hospitalization interval, mode of delivery and maternal complications. Results: Among 2200 consecutive recorded deliveries, 50 women were eclamptic, yielding a frequency of 2.2%. The antenatal / intrapartum and postpartum incidences of eclampsia were 72%, and 28% respectively. All patients were unbooked and belonged to low socioeconomic class. A total of 19 maternal deaths occurred during the study period. Four out of these were due to eclampsia. Maternal mortality rate form eclampsia was 8% and accounted for 21% of the total maternal deaths during the study period. Maternal complications occurred in 20(40%) patients while 26(52%) patients had smooth uncomplicated recovery. Conclusion: Eclampsia is still responsible for considerable morbidity and mortality for the mother and baby. HELLP (Haemolysis, Elevated liver enzymes, low platelet count) renal failure, coagulopathy and pulmonary edema are its serious complications. Prevention of eclampsia is a challenge. This challenge can be met only, if there is a willingness to invest more in maternal health. Improved antenatal care, early detection and aggressive management of severe pre-eclampsia will reduce the incidence of eclampsia and its dreadful complications.