A Study of Fetomaternal Outcome In Eclampsia - A Case Control Study

摘要

Introduction: In India, reported incidence of eclampsia varies from 0.179 to 3.7 %. And maternal mortality varies from 2.2 to 23 % of all eclamptic women. India the perinatal and maternal outcome is still poor due to inadequate antenatal care in rural areas, financial restraints and non-availability of transportation facilities, and social taboos causing delay in management resulting in poor maternal and neonatal outcome. Methodology: The current study was a Case control study, done among cases of Eclampsia admitted to the labour room of SSSH, Baroda in Gujarat. Patient immediately preceding each case and patient immediately succeeding each case not having Eclampsia having similar Parity and Gestational age were included as controls. Permission to conduct the study was obtained from Ethical Committee of Institute. Total 70 patients of Eclampsia presented in this institution during the study period. Accordingly 140 controls were included in the study. Fetomaternal outcome of all Cases and Control were compared and analysed. Results: Out of 70 cases 56 (80%) were of Antepartum eclampsia, 02 (2.9%) were of Intrapartum eclampsia & 12(17.1%) were Postpartum eclampsia. Out of total 70 cases, 46 (65.7%) were full term delivery. Out of total 46 live births among cases and 106 live births among controls, 40 (86.9%) Cases and 87(82.1%) Controls were fullterm (>37 weeks). Out of total 24 Still birth in cases and 34 still birth in controls, 18(75.0) Cases and 24(70.6%) Controls were preterm (<37 weeks). Among the cases, 34(48.6%) babies had birth weight between 1000-2000 grams against 53(37.8%) controls who belong to the same category. The incidence of low birth weight in eclampsia is attributed to prematurity & IUGR. The maternal mortality was high in the Case group i.e. 8.57%. There was no maternal mortality in the Control group. Causes of mortality includes Cerebrovascular haemorrage, DIC with renal failure, HELLP Syndrome with Cerebral malaria, Hepatic encephalopathy and Pulmonary edema sec. to aspiration. Conclusion: The maternal and Infant mortality was high in the Eclamptic patients. Causes of mortality includes Cerebrovascular haemorrage, DIC with renal failure, HELLP Syndrome with Cerebral malaria, Hepatic encephalopathy and Pulmonary edema sec. to aspiration.