Eclampsia is the leading cause of maternal and perinatal mortality as well as morbidity. This prospective study was carried out at PMCH, Dhanbad
Aim and objectives: (1) To evaluate the rate of eclampsia in antenatal women attending our hospital, (2) to evaluate the epidemiological factors and clinical presentation in women with eclampsia, (3) to analyze the maternal and perinatal outcome in women with eclampsia, and (4) to formulate strategies to improve the maternal and perinatal outcome.
Methodology: It is a prospective study, carried out on 100 pregnant women admitted with severe pre-eclampsia and eclampsia at PMCH, Dhanbad. Detailed history and examination was carried out. Investigation like complete hemogram, liver function tests, renal function tests, coagulation profile, fundus and 24 hour urine for protein were done. Obstetric management was done as per existing protocol in the department, magnesium sulphate was the drug of choice for controlling convulsions and blood pressure was controlled either by oral nefidipene or Labetalol. Maternal and perinatal complications were noted down.
Results: The majority of the patients was unbooked (80%), belonged to lower socioeconomic status (82%) and had rural background (82%). Headache was the most common antecedent symptom (44%) followed by epigastric pain (20%), oliguria (9%), blurring of vision (8%) and ascitis (5%). There was high incidence of maternal complication like PPH (31%), abruption placentae (11%), renal dysfunction (8%), pulmonary edema (8%), pulmonary embolism (4%), HEELP syndrome (2%) and DIC (2%). Maternal mortality was 8% and the causes were pulmonary embolism in four women, DIC in two, HELLP and pulmonary edema in one each. Perinatal complications were also high 71.43% were low birth weight, 66% had preterm delivery, 52.4% babies had birth asphyxia and 28.57% were still born Maternal and perinatal outcome was much poorer in eclampsia as compared to severe pre-eclampsia.
Conclusion: There is a very high maternal and perinatal morbidity and mortality and 80% jpatients had no antenatal care. Good antenatal care could have been prevented severe pre-eclampsia and eclampsia to some extent. Thus it is suggested that developing countries have to go a long way to create awareness about importance of antenatal checkups and take measures for implementation.
