Preliminary outcome of the management of eclampsia at the Imo State University Teaching Hospital

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.
Aim: This study aims at determining the prevalence and management outcome of  eclampsia in our centre with a view to proffering solutions for an optimal or near optimal care.
Methods: A retrospective review of the case records of patients managed for eclampsia at the Imo State University Teaching Hospital (IMSUTH), Orlu from 1st October 2004 to 30th September 2009 was carried out. Data on socio-demographic characteristics as well as clinical management and outcome were extracted and analyzed.
Results: The prevalence of eclampsia was 2.7% of all the deliveries. The prevalence was significantly higher in the unbooked than the booked patients (p<0.05). The prevalence was also significantly higher in primigravidae than in multiparae (p<0.05). Twenty-eight (93.3%) of the eclampsia occurred antepartum. Twenty-eight (93.3%) had severe hypertension on presentation. Twenty nine (95.8%) of the patients had 2-5 episodes of convulsions prior to presentation to the hospital.  Twenty-six (86.7%) of the patients had emergency Caesarean section was carried out, mostly for unfavourable cervix. The perinatal mortality was 6.7% while maternal mortality was 3.3%. Complications included acute renal failure, aspiration pneumonitis and abruptio placentae.
Conclusion: The prevalence of eclampsia is unacceptably high in our centre. Early antenatal booking, antenatal care follow-up to identify the imminent signs and prompt treatment of cases of pre-eclampsia will reduce the burden of eclampsia in this environment.

Keywords: Eclampsia, Prevalence, Morbidity, Mortality, Orlu