Risk factors for morbidity and mortality in eclampsia – a prospective study

Objective: To know risk factors for morbidity and mortality in eclampsia and analysing the preventable and non-preventable factors for development of eclampsia.
Material & Methods: The present study was conducted on a prospective basis for one and half year, from 1st Jan 2014 to 30 th June 2015 in the Department of Obstertics and Gynaecology, Govt. Medical College and Rajindra Hospital, Patiala in all cases of eclampsia .
Results: Total deliveries during this study period were 5494 with total cases of eclampsia were 185. Thus incidence came out to be 3.36%. The risk factors for eclampsia as observed in study were age group 20-25 years ;primigravida; patients coming from rural area with low socioeconomic status with no or irregular antenatal checkups. About 74 patients had complications. The risk factors associated with maternal morbidity in cases of eclampsia were low socioeconomic status (70.27%); rural background (63.51%) and illiterate (40.54%); no or irregular antenatal checkups (66.22%). Primigravida (59.46%) in age group 20-25 years (56.76%) had more complications. Maternal morbidity was also increased in referred cases (74.33%) and that too distance beyond 60 kms (45.40%). More complications were also observed in patients when fit-treatment >3 hours(58.11%) after onset of convulsions. Antepartum eclampsia (70.27%) also significantly contribute to maternal morbidity. The maternal mortality was 1.62%.
Conclusions: Eclampsia is stil common cause for maternal morbidity and mortality. The preventable factors for eclampsia in present study were No or irregular antenatal checkups; Non-compliance with anti-hypertensives; No treatment at referral center; Delayed treatment (prolonged fits-treatment interval); Delay between onset of convulsions and admission to hospital. In 16.21% eclampsia occurred suddenly and hence it was not preventable in these cases.