TO STUDY MATERNAL & FETAL OUTCOMES IN CASE OF ECLAMPSIA- A SINGLE CENTER STUDY.

Abstract

Background - Eclampsia is defined as the onset of convulsions or coma during pregnancy or post-partum in a patient who has signs and symptoms of preeclampsia. Eclampsia is a life-threatening emergency that continues to be a major cause of serious maternal morbidity and is still the leading cause of maternal mortality worldwide.

Aims- To study maternal & fetal outcomes in case of eclampsia- a single center study.

Materials and methods- The proposed study is a prospective study centered in Obstetrics & Gynecology Department RIMS, Raipur during the term between January 2023 to June 2024 in total 50 patients. Pregnant women who have been diagnosed with eclampsia with more than 20 weeks of gestation and up to 42 days postpartum coming to hospital. Pregnant women with medical complications like: Pre-existing hypertensive, Diabetes, Renal disease and Pre-existing liver disease ets are excluded. Statistical analysis has been done using Chi-square test by SPSS software. Result (both perinatal and maternal deaths) are presented as number and percentage.

Results- The present study shows prevalence of Eclampsia is 0.9 % at our tertiary care center. Majority of the cases with Eclampsia were detected in age group of 20-25 year (58 %). Eclampsia was more common in primiparous patient (76%) which belonged to lower socio- economic status (94%). 9 were having high risk factor out of which 4 were past history of PIH, 2 had family history of eclampsia, 2 were obese, and one had profound hypertension. Eclampsia was more prevalent in antepartum cases (84%) followed by postpartum period (10%). Majority of women with eclampsia were between gestational age of 33-36 week (48%). 11 patients developed complication which was 31% due to PPH, 25% due to DIC, 19% due to HELLP, 13% due to Pulmonary edema ,6% due to PRES, 6% due to ARF. Mortality rate was 4%. Reason of death ARF and pulmonary edema.

Total live birth rate amongst 50 eclampsia patient was 100% out of which majority of them weighed between 2.1 - 2.5 kg and majority of them had APGAR score >7 (50%). Of all 100 % live births, 58% neonates needed NICU admission, of which 11% of neonates died majority of died (73%) due to RDS. Most of mortality occurs in less than 1 kg baby weight. Out of 27 babies complicated in eclamptic deliveries most common complication was RDS and LBW. Of all eclampsia patients, all were given MgSO4 therapy out of which 94% responded well and 6% presented with repeated convulsion which were managed by Levetiracetam. Only 2 patients developed gluteal abscess after mgso4 treatment.

Conclusion- Early attention and intensive management are essential for improving the maternal and fetal outcome in eclamptic cases. Unless the social and educational status of women are uplifted and obstetric care is brought to the doorstep, no miracle can be expected. A moderate reduction of death of mother and fetus in our institution was possible due to wider use of magnesium sulphate, timed delivery, proper implementation of emergency obstetric care facilities to mother with eclampsia.