Maternal outcome in eclampsia in MKCG medical college and hospital, Berhampur, Odisha

Apply

Maternal outcome in eclampsia in MKCG medical college and hospital, Berhampur, Odisha

Journal Title: Medpulse International Journal of Gynaecology - Year 2017, Vol 3, Issue 3

Abstract

Objective: Hypertensive disorders complicate 5-10% of all pregnancies globally¹& 10.08% in India. Eclampsia is an obstetric enigma and a major cause of serious maternal morbidity and maternal mortality. Majority of the death occurs in the developing countries and most of them are preventable. Prevalence of eclampsia is 1-5% and the maternal mortality rate related to eclampsia varies worldwide from 1.8% in the UK up to 43.1% in Nigeria. ²•³ It is the cause for about 8-14% of maternal mortality in INDIA i.e 200 mothers per day. In MKCGMCH it accounts for 8.-15 % of maternal mortality. Methods: A descriptive cross-sectional study was carried out between September 2014 to August 2016 in the Department of Obstetrics and Gynaecology at MKCG MCH, Berhampur .Our study population included all eclamptic mothers admitted to O&G department, MKCG MCH. After obtaining appropriate informed consent maternal data was collected which included maternal demographic characters, data from previous antenatal clinic which included number of ANC, admission blood pressure, proteinuria, number and timing of seizure activity. Lab values of interest included complete blood count, LFT, RFT, coagulation profile and fundoscopy. The outcomes examined were incidence of eclampsia in relation with age, parity, literacy, maternal morbidity and mortality due to pulmonary oedema, PPH, ARF stroke, HELLP syndrome, abruptio placentae, disseminated intravascular coagulation (DIC) etc. Patients were treated with general supportive measures and Anticonvulsants: MgSO4 and Antihypertensive: BP ≥160/110mmHg, labetolol. Results: Maximum patients were 21-25years(63.3%).Maximum Eclampsia were primiparous around 83.5% .maximum patients were of 34-37 wk Gestational age. Eclampsia were more common in illiterate & those had not done ANC. Maximum 70.64% cases were from low socioeconomic status, maximum 63.3% cases were referred from peripheral hospitals62.38 % cases were having severe hypertension at the time of admission, delayed in admission or treatment more than 5 hours resulted in case fatality rate 75%, 100% maternal deaths observed in patients admitted with comatose state followed by > 5 convulsion cases with 50 % maternal death. Patients who delivered after 24 hr. were having max mortality rate50%. 20.18 % patients required to be managed in HDCU .highest mortality (CFR -8.64%) seen in antepartum eclampsia followed by postpartum (CFR -8%).CFR was more in multiparous (CFR 16.67%) than primiparous .case fatality rate more in VD case .maternal morbidity causes were pyrexia,pulmonary edema, PPH, ARF,DIC, septicemia. Maximum death occurred due to pulmonary edema 44.44% followed by PPH,DIC. Conclusion: Eclampsia is the reflection of poverty, illiteracy and lack of awareness. So increased female literacy to avail the antenatal care, early diagnosis, primary management and referrals need to be improved. The medical officers and nurses working at periphery should be trained properly regarding proper and early management of pre- eclampsia and eclampsia. The referral transport services and HDCU should be improved to reduce maternal morbidity and mortality releated to eclampsia.

Authors and Affiliations

Subhesh Kumar Bhol, Anee Verma, Bharati Misra

Keywords

Eclampsia Liver function test Renal function test pulmonary edema postpartum hemorrhage acute renal failure stroke HELLP syndrome DIC fundoscopy abruptio placentae ARDS

EP ID EP259825
DOI -
Views 190
Downloads 0