DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20204241

Evaluation of maternal and perinatal morbidity and mortality in eclampsia by early termination of pregnancy

Suresh C. Mondal, Sandip Lahiri

Abstract


 

Background: Eclampsia is one of the leading causes of maternal mortality in India.

Methods: A prospective observational study was done on 200 pregnant women admitted with antepartum eclampsia in Malda Medical College from 1 April 2017 to 30 October 2019. Group A included patients who delivered through vaginal route within 10 to 12 hrs of eclampsia by stabilisation of patients while Group B included subjects who underwent early caesarean section for uncontrolled convulsions or poor Bishop score. Maternal and perinatal outcomes were compared between the groups. Data was recorded in a pretested performa and was analyzed using appropriate statistical methods with SPSS.

Results: Caesarean section (group B) was done in 130 cases (65%) while vaginal delivery (group A) was done in 65 cases (37.5%). Group A had higher maternal mortality (10.7%) in comparison to group B (4.6%) which was statistically not significant (p=0.1075). There were 32 neonatal deaths (24.6%) and 11 still births (8.46%) in group A while there were 12 neonatal deaths (18.46%) and 3 still births (4.61%) in group B. There was a statistically significant difference (p<0.0001) between the groups with respect to total perinatal deaths.

Conclusions: Antenatal and intranatal eclampsia should be managed by early termination of pregnancy preferably with Caesarean section. Early presentation and timely decision to terminate pregnancy will improve the maternal and perinatal outcome.


Keywords


Antepartum, Eclampsia, Hypertensive disorders of pregnancy, Early termination, Caesarean section, Vaginal delivery, Maternal mortality, Perinatal mortality

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References


World Health Organization. Trends in maternal mortality: 1990 to 2015. Estimates by WHO, UNICEF, UNFPA, World Bank and the United Nations Population Division. Geneva, Switzerland: World Health Organization; 2015. Available at: http://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2015/en/. Accessed on 10 May 2020.

Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol 2013;170(1):1-7.

WHO Recommendations for Prevention and Treatment of Pre-Eclampsia and Eclampsia. Geneva: World Health Organization; 2011. 1, Background. Available from: https://www.ncbi.nlm.nih.gov/books/NBK140563/. Accessed on 10 May 2020.

Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol 2009;33(3):130-7.

Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet 2010;376(9741):631-44.

Nobis PN, Hajong A. Eclampsia in India Through the Decades. Journal of obstetrics and gynaecology of India 2016;66(Suppl 1):172-6.

Swain S, Ojha KN, Prakash A, Bhatia BD. Maternal and perinatal mortality due to eclampsia. Indian Pediatr 1993;30(6):771-3.

Magpie Trial Follow-Up Study Collaborative G. The Magpie Trial: a randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for women at 2 years. BJOG : an international journal of obstetrics and gynaecology 2007;114(3):300-9.

Un Nisa S, Shaikh AA, Kumar R. Maternal and Fetal Outcomes of Pregnancy-related Hypertensive Disorders in a Tertiary Care Hospital in Sukkur, Pakistan. Cureus 2019;11(8):e5507-e.

Shaikh SB, Jampala S, Devi SS, Mallika.A study on maternal and perinatal out comes in cases of eclampsia admitting to government medical collegeand general hospital, Anantapuramu, Andhra Pradesh, India.Int J Reprod Contracept Obstet Gynecol 2016;5:2146-50.

Yakasai IA, Gaya SA. Maternal and fetal outcome in patients with eclampsia at Murtala Muhammad specialist Hospital Kano, Nigeria. Ann Afr Med 2011;10(4):305-9.

Kurude VN, Kokate PH, Saha D, Jha EK. Study of maternal and perinatal outcome in eclampsia. Paripex Ind J Res 2017;6(4):63-5.

Jido TA. Ecalmpsia: maternal and fetal outcome. African health sciences 2012;12(2):148-52.

Rabiu KA, Adewunmi AA, Ottun TA, Akinlusi FM, Adebanjo AA, Alausa TG. Risk factors for maternal mortality associated with eclampsia presenting at a Nigerian tertiary hospital. Int J Womens Health 2018;10:715-721

https://doi.org/10.2147/IJWH.S178729.

Tukur J, Muhammad Z. Management of eclampsia at AKTH: before and after magnesium sulphate. Niger J Med 2010;19(1):104-7.

Hussain F, Johanson RB, Jones P. One year survey of maternal mortality associated with eclampsia in Dhaka Medical College Hospital. J Obstet Gynaecol 2000;20(3):239-41.

Das R, Biswas S. Eclapmsia: The Major Cause of Maternal Mortality in Eastern India. Ethiopian journal of health sciences 2015;25(2):111-6.

von Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy. Best practice & research Clinical obstetrics & gynaecology 2016;36:83-102.

Abraham C, Kusheleva N. Management of Pre-eclampsia and Eclampsia: A Simulation. MedEdPORTAL : the journal of teaching and learning resources 2019;15:10832-.