Presentation and Management Outcome of Eclampsia at AlElwiya Teaching Hospital

Abstract

ABSTRACT: BACKGROUND: Eclampsia is a life-threatening complication of pregnancy for both the baby and the mother. Research isunderway to understand this complex condition and to improve the treatments that are currently used tocontrol it as it is a preventable complication of pre-eclampsia.OBJECTIVE: The study reviews the cases of eclampsia managed at Elwiya teaching Hospital with respect toincidence, management, maternal and perinatal outcome. METHODS: This prospective observational study was carried out in the department of Obstetrics and Gynaecologyat Elwiya Teaching Hospital – Baghdad-Iraq. Fifty two cases of eclamptic fits were dealt with from the1st of January till the 31st of December 2008. Pregnant patients with other convulsive disorders andmore than 7 days postpartum were excluded from the study. All the patients included were evaluated bydetailed history (taken from the attendants). Management was according to basic protocol foreclampsia; stabilization of patients, anticonvulsive therapy Magnesium sulfate, phenytoin and/ordiazepam and early delivery. A team of specialists and trained nurses were needed in the intensive careunit to deal with eclamptic mothers.RESULTS: During the year 2008, total number of deliveries from the 1INTRODUCTION: Eclampsia is one of the fatal complications of preeclampsiawhich is a multisystem disorder; itpresents a challenge to obstetricians and otherphysicians. Eclampsia is defined as seizure activityunrelated to other cerebral conditions in a pregnantwoman with pre-eclampsia. The condition wasknown to the ancient Greeks, who named it eclampsia. It has been prevalent since the time ofHippocrates; it remains an important cause ofmaternal mortality throughout the world,accounting for about 50000 deaths worldwide.Department of Obstetrics and Gynecology atElwiya Teaching Hospital – Baghdad . (1)st of January till the 31An eclamptic seizure occurs in 0.5% of mildly preeclampticpregnancies and 2% of severe preeclamptics.(2) st of December was12154, of these patients 52 presented with eclamptic fit with incidence rate of 4.28 per 1000 deliveries.The distribution of cases regarding the seasons was more in winter. 35 patients (67.31%) had poorantenatal care, 17 (32.69%) had good antenatal care. Four patients had history of eclampsia in theirprevious pregnancies. All the patients gave history of imminent eclampsia; two of them had blindnessalso; albumin in urine was negative in two cases only. Serious maternal complications occurred in28(53.84%) cases. Eight of the neonates died due to severe RDS.CONCLUSION: Eclampsia is still present and common in our locality; we need better antenatal care to predict pregnantladies liable to develop eclamptic fit in order to decrease the incidence of eclampsia complicatingpregnanc