Comparative study of vaginal delivery and caesarean section in antepartum eclampsia at tertiary care hospital

Authors

  • Priti Kumari Department of Obstetrics and Gynecology, KMC, Katihar, Bihar, India
  • Sipra Singh Department of Obstetrics and Gynecology, KMC, Katihar, Bihar, India
  • Salma Khatun Department of Obstetrics and Gynecology, KMC, Katihar, Bihar, India
  • . Shashikar Department of Obstetrics and Gynecology, KMC, Katihar, Bihar, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20170007

Keywords:

Antepartum eclampsia, Caesarean section, Vaginal delivery

Abstract

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.

Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.

Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.

Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.

References

Dutta DC. Textbook of Obstetrics. 8th Ed. Calcutta. New Central Book Agency Pvt. Ltd.; 1998: 234-254.

Williams Obstetrics. 24th Ed., McGraw Hill Co. Inc., 2005:761-808.

Knight M. Eclampsia in the United Kingdom 2005. BJOG. 2007;14(9):1072-8.

Turner IA. Diagnosis and Treatment of pre-eclampsia: an update. International Journal of women’s Health. 2016; pp. 327-337.

World health organization. Reduction of Maternal mortality. A Joint WHO/UNFDA/UNICEF AND WORLD BANK statement Geneva WHO: 1999.

Fernando Arias' Practical Guide to High-Risk Pregnancy and Delivery, 4th Edition. pp. 424-427.

Eclampsia Working Group: Eclampsia in Bangladesh, a review and a guide line. Bangladesh J Obstet Gynecol. 1996;12:1-25.

Prabhakar G, Shinde MA, Jadhav CA. clinical study of eclampsia patient at Dr. V.M. government Medical College Solapur, India. JOSR. 2015;13(7):10-6.

Choudhary P. Eclampsia: A hospital based Retrospective study. Kathmandu University Medical Journal. 2003;J(4):237-41.

Bhattacharya PK, Purkayastha, Basu M. Robinsanath M. caesarean section in eclampsia still a dilemma. J Obstet and Gynecol. 1992;42(1):51-5.

Dandekar LM. Eclampsia: perinatal hospital experience. JI Obstet and Gynecol. 1993;43(1):42-4.

Smite J. Perinatal mortality in eclampsia. J Obstet Gynecol. 1989;39:792-4.

Mario Lopez - Llera, Rubio Linares and Hernandez Horta. Maternal mortality rates in eclampsia. Amj of Obsatetic and Gynecol. 1983:146-307.

Menon K. Cesarean section in eclampsia. J Obstet Gynecol. British EMP. 1961: 68-461.

Hakerwadi AV, Taner CE, Garden AC, Ozelbaykal V. Prevalence, management and outcome in eclampsia. Lancet. 1996;348(9024):364-9.

Habeebullah S, Agarwal A, Swain S, Arora R. Impact of mode of delivery on maternal mortality in eclampsia. JIMA. 1997;95(40).

Sheehan HL, Lynch JB. Cerebral lesion in: Pathology of toxaemia of pregnancy. Baltimore. Williams and Wikins, 1973.

Abdullah AR, Nalliah S. Eclampsia in Kelantan. West Aft Med. 1990;9(3):157-63.

Mitraand S, Das K. Management of eclampsia. J of obstet and Gynec Brit Emp. 1957:64:74-8.

Sibai BM, Ramadan MK. Maternal morbidity and mortality in 442 pregnancies with HELLP syndrome. Am J Obstet Gynecol. 1991;174:454.

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Published

2017-01-31

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Original Research Articles