Maternal mortality associated with eclampsia in Sokoto, Nigeria

Abstract

Background: Eclampsia is a well recognised major cause of maternal death particularly in developing countries where illiteracy, poverty, lack of prenatal care, late referral, lack of efficient transport system and delay in hospitalization abound.
Objective: To determine the proportion of maternal mortality associated with eclampsia together with the demographic and clinical characteristics that influence death in eclamptics.
Methods: Records of all the maternal deaths due to eclampsia at Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto between January 2005 and December 2009 were reviewed, retrospectively. Their social demography, mode of delivery, type of eclampsia, Glasgow coma score at presentation and fetal outcome were extracted for analysis. The data were processed with SPSS version 10. Chi square was used to analyse some of the results and the confidence limit was set at 95%.
Results: There were 277 maternal deaths during the five-year period and eclampsia accounted for 117 (42.2%) deaths, with a case fatality of 31.7%. The case fatality from the condition was relatively higher in mothers whose age was less than 20years (36.2%), of first delivery (33.8%), with no formal education (32.4%), with no prenatal care (32.3%) and with Glasgow coma score of ≤5 at presentation (46.1%) than their opposite numbers. However, it was only in Glasgow coma score that a significant difference in case mortality was observed (p = 0.000). The perinatal death associated with eclampsia was 24.7%, and 61.5% of them occurred amongst mothers who died from eclampsia.
Conclusion: Eclampsia is a major contributor to maternal mortality in the centre. Measures to reduce maternal death from eclampsia include female education, promotion of utilization of family planning and prenatal/delivery services and health education on features of severe pre-eclampsia and early presentation to the hospital at the least suspicion.

Keywords: Eclampsia, maternal mortality, Sokoto