Abstract: Background: Eclampsia continues to be a major cause of maternal and perinatal mortality in developing countries. Early identification and management of pre- eclampsia will help reduce the mortality due to eclampsia.
Objective: To determine the maternal and fetal outcome of patients with eclampsia.
Study setting and period: Gynaecology and Obstetrics department of admitted of Upzilla Helth complex, Thakurgaon, Bangladesh, between January 2022 to June 2023.
Study population: The study population was eclampsia with singleton pregnancies presenting during the study period admitted the Department of Obstetrics and Gynecology in Upzilla Helth complex, Thakurgaon, Bangladesh, Bangladesh.
Methods: This cross sectional study of pregnancy outcomes of eclampsia patients. 50 eclampsia patients were taken in this study. Eclampsia was defined as the occurrence of seizures in the presence of preeclampsia (shown by hypertension diastolic blood pressure of at least 90 mmHg, proteinuria one "plus" or at least 0.3 g/24 h occurring after 20 weeks gestation). Patients with any cause for convulsion other than eclampsia were excluded. All the patients taken in this study was admitted in the hospital (inpatients) both in wards and in emergency rooms. All the patients included in the study was evaluated by detailed history, through physical examination and relevant laboratory investigations like blood complete picture, platelet count, coagulation profile, renal function tests, serum electrolytes, uric acid, blood glucose level and urine protein examination.
Results: Almost two third (62.0%) patients belonged to age ≤20 years, 64.0% patients were housewives and more than a half (52.0%) of the patients came from lower class family. Majority (58.0%) patients were nulli para, 44.0% of the patients received antenatal check-up regularly and the mean duration of pregnancy was 36.8±3.1 weeks. Regarding the mode of delivery, it was observed that 18(36.0%) patients had normal vaginal delivery and 32(64.0%) underwent caesarian section among them, 8(25.0%) patients was found post-dated pregnancy, 6(18.8%) were failed induction, 5(15.6%) were cephalo pelvic disproportion, 5(15.6%) were obstructed labour, 4(12.5%) were fetal distress, 2(6.3%) were placenta previa, 1 (3.1%) were pre eclampsia and 1(3.1%) was Rh-ve mother. Almost two third (61.1%) babies were alive in vaginal delivery and 29(90.6%) in caesarean section. The difference was statistically significant (p<0.05) between two groups. The mean birth weight was found 2.71±0.73 kg in vaginal delivery and 2.7±0.49 kg in caesarean section. The mean birth weight was not statistically significant (p>0.05) between two groups. APGAR score at 1 minute, at 5 minutes. Pulmonary oedema was found 4(22.2%) in vaginal delivery and not found in caesarean section. Postpartum psychosis was found 3(16.7%) in vaginal delivery and not found in caesarean section. Which were statistically significant (p<0.05) but other maternal complication were not statistically significant (p>0.05) between two groups.
Conclusion: To compare the outcome of labour in vaginal delivery with that of Caesarean section in patients presenting with eclampsia. In this study, mode of delivery has shown significant difference in maternal outcome. The high incidence of eclampsia and its complications during this study period may indicate the need for earlier and more meticulous intervention at both the clinic and hospital levels.
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