Eclampsia: Analysis of factors leading to morbidity in Indian scenario

Dr Ajay Chhikara; Dr Archana Bharti

Volume : VI, Issue : VI, June - 2016

Eclampsia: Analysis of factors leading to morbidity in Indian scenario

Dr Ajay Chhikara, Dr Archana Bharti

Abstract :

 Introduction: Eclampsia is a leading cause of maternal and perinatal mortality and morbidity worldwide. Incidence of eclampsia in India has been reported as 3.2 per 1000 deliveries. Deaths due to eclampsia are secondary to preventable factors. Aim of the study is to identify the etiological factors and lacunae in health care delivery responsible for eclampsia. Material and methods: A retrospective study of 100 women diagnosed as eclampsia at Maharaja Agrasen Medical College, Agroha from January 2011 to June 2013 was done. Demographic information was obtained. Detailed history of prior antenatal care, premonitory symptoms, time of convulsions, blood pressure and urine albumin at time of convulsion, any primary treatment at referral, time lapsed during transfer of patient were taken. Continuous variables were summarized with mean and standard deviation. Categorical variables were summarized using number and percentages. Results: Majority of patients were primigravida (66%) and in between 21–25 years (61%). 72% women had no antenatal visits. 83% of the women had premonitory symptoms. Most patients convulsed in antenatal period (78%) with very few in intranatal (13%) and postnatal (9%) period. Only 23% of cases received MgSO4 and 31% treated with antihypertensives at the periphery. 16% patients were referred in <2 hours, 65% in 2–4 hours and 19% in > 4 hours. Conclusion: It can be concluded that better antenatal care, proper surveillance during antenatal period, robust referral systems and infrastructure at primary and secondary health care centres, early initiation of treatment of eclamptic patients and strengthening of tertiary health care systems can improve outcome.