Eclampsia: a comparative study in a tertiary hospital setting in South-South Region of Nigeria

Authors

  • Eugene M. Ikeanyi Department of Obstetrics and Gynecology, Niger Delta University Teaching Hospital Okolobiri, Bayelsa State, Nigeria
  • Isaac J. Abasi Department of Obstetrics and Gynecology, Niger Delta University Teaching Hospital Okolobiri, Bayelsa State, Nigeria

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20202312

Keywords:

Eclampsia, Incidence, Maternal, Nigeria, Outcome, Perinatal, Risk factors

Abstract

Background: Eclampsia remains a leading cause of maternal and perinatal morbidity and mortality often in settings of poor health seeking behaviour and services. Objective of this study was to determine the incidence, investigate the risk factors, obstetric outcomes and suggest ways of improving the impact of eclampsia.

Methods: An analytical observational study on consecutive cases of eclampsia managed in a tertiary hospital setting from 2014 to 2019. For each case of eclampsia recruited the next gestational hypertensive and normotensive cases managed in the period were recruited to serve as controls. Computer statistical software, Chi square for test of associations were used for analysis with statistical significance set at p<0.05.

Results: Among 3625 deliveries within the study period were 57 cases of eclampsia; an incidence of 1.57%. Most (74.4%) were antepartum eclampsia. Majority of the eclamptic mothers were unbooked (81.4%), of lower social class (86.0%), poorly educated (81.4%) and nulliparous (58.1%). Eclamptic mothers were more likely to be youth ≤24 years (39.5%), teenagers (25.6%), and unmarried. Twenty-four (55.8%) had abdominal delivery, anaemia (23.3%) and were transfused. Three women died from eclampsia; a case fatality of 6.98%. Twenty-four (55.8%) neonates were preterm, low birth weight (48.8%), intrauterine growth restriction (25.6%), special care baby unit admission (32.6%) and perinatal mortality 13 (30.2%).

Conclusions: Eclampsia is still an un-mitigating malady in this study settings with increased maternal and perinatal complications. Nulliparity, low social status, young age and lack of prenatal care appeared significant risk factors. Quality prenatal care, early detection and management of pre-eclampsia will mitigate eclampsia occurrence and severity. Women empowerment is proffered.

References

Lavanya SG, Ganitha G. A prospective study of pregnancy outcome in eclampsia. Indian J Obstet Gynecol Res. 2017;4(1):26-2.

Sharara HA. A review of eclampsia in Qatar: a twenty-year study (from January 1991- December 2009). Qatar Med J. 2012;2:7-15.

Fugate SR, Gregory E, Chow. Eclampsia 2005, E-medicine Last Updated October 5, 2005.

Agida ET, Adeka BI, Jibril KA. Pregnancy outcome in eclamptic at the University of Abuja Teaching Hospital, Gwagwalada, Abuja: A 3 year review. Niger J Clin Pract. 2010;13:394-8.

Adekanle DA, Akinbile TO. Eclampsia and pregnancy outcome at Lautech Teaching Hospital, Osogbo, South West, Nigeria. Clinics Mother Child Health. 2012;9(1):1-4.

Olusanya O, Okpere EE, Ezimokhai M. The importance of social class in voluntary fertility control in a developing country. West Afr J Med. 1985;4:205‑12.

Okoror CEM. Maternal and perinatal outcome in women with eclampsia: a retrospective study at the University of Benin Teaching Hospital. Int J Reprod Contracept Obstet Gynecol. 2019;8(1):108-14.

Olatunji AO, Sule Odu AO. Presentation and outcome of eclampsia at a Nigerian University Hospital. Niger J Clin Pract. 2007;10(1):1-4.

Adamu AN, Ekele BA, Ahmed Y, Mohammed BA, Isezuo SA, Abdullahi AA. Pregnancy outcome in women with eclampsia at a tertiary centre in northern Nigeria. Afr J Med Med Sci. 2012;41(2):211-9.

Umezulike CC, Feyi Waboso PA, Whittaker RC Treatment of eclampsia with magnesium sulphate in Aba, South- Eastern Nigeria. Trop J Obstet Gynaecol. 2006;23(1):20-2.

Ghosh MD, Singh V, Ray A. Maternal and foetal outcome of eclampsia in a referral hospital. Int J Reprod Contracept Obstet Gynecol. 2017;6(3):1021-4.

Dora SK, Nayak L, Pande B, Dandapat AB. A prospective observational study for the evaluation of maternal and fetal outcome in patient with eclampsia. Int J Res Med Sci. 2017;5:1785-9.

Esike CO, Chukwuemeka UI, Anozie OB, Eze JN, Aluka OC, Twomey DE. Eclampsia in Rural Nigeria: The unmitigating Catastrophe. Ann Afr Med 2017;16:175-80.

Onuh SO, Aisien AO. Maternal and fetal outcome in eclamptic patients in Benin City, Nigeria. J Obstet Gynaecol. 2004;24(7):765-8.

Okafor UV, Efetie ER, Ekumankama O. Eclampsia and seasonal variation in the tropics - a study in Nigeria. Pan African Med J. 2009;2(7):1-6.

Praxton A, Maine D, Hijab N. Using the UN process indicators of emergency obstetric services questions and answers. Aver Mat Death Disabil Program. 2003:6.

Robson SC. Hypertension and renal disease in pregnancy. In: Edmonds DK (ed.) Dewhurst's Textbook of Obstetrics and Gynaecology for postgraduates, sixth edition. Blackwell science Ltd, London; 1999:166-185.

Ekele BA, Badung SLH. Is serum magnesium estimate necessary in patients with eclampsia on magnesium sulphate? Afr J Reprod Health. 2005;9(1):128-32.

Efetie ER, Okafor UV Maternal outcome in eclamptic patients in Abuja, Nigeria A 5-year Review. Niger J Clin Prac. 2007;10(4):309-13.

Egeonu RO, Obiechina NJA, Okolie VE. Eclampsia and its fatality associations In Nnamdi Azikiwe University Teaching Hospital, Nnewi. J Dent Med Sci. 2017;16(5):111-6.

Kechebelu JI, Okoli CC. Review of eclampsia at the Nnamdi Azikiwe University Teaching Hospital, Nnewi. (January 1996-December 2000). J Obstet Gynaecol. 2002;22(3):287-90.

Altman D, Carroll G, Duley L, Farrell B, Moodley J, Neilson J, Smith D. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomized placebo-controlled trial. Lancet. 2002;359(9321):1877-90.

Obed SA, Wilson JB, Elkins TE. Eclampsia: 134 consecutive cases. Int J Gynecol Obstet. 1994;45(2)97-103.

Hlimi T. Association of anemia, pre-eclampsia and eclampsia with seasonality: a realist systematic review. Health Place. 2015;180-92.

Jamelle RN. Eclampsia: is there a seasonal variation? J Obstet Gynaecol. 1998;24(2):121-8.

Kullima AA, Kawuwa MB, Audu BM, Usman H, Geidam AD. A 5-year review of maternal mortality associated with eclampsia in a tertiary institution in northern Nigeria. Ann African Med. 2009;8(2):81-4.

Elongi JP, Tandu B, Spitz B, Verdonck F. Influence of the seasonal variation on the prevalence of pre-eclampsia in Kinshasa. Gynecol Obstet Fertil. 2011;39:132-5.

Wacker J, Schulz M, Fruhauf J, Chiwora FM, Solomayer E, Bastert G. Seasonal change in the incidence of preeclampsia in Zimbabwe. Acta Obstet Gynecol Scand. 1998;77:712-6.

United N. The Millennium Development Goals Report 2014. New York: United Nations; 2014.

Brantsaeter AL, Haugen M, Samuelsen SO, Torjusen H, Trogstad L, Alexander J. A dietary pattern characterized by high intake of vegetables, fruits, and vegetable oils is associated with reduced risk of preeclampsia in nulliparous pregnant norwegian women. J Nutr. 2009;139(6):1162-6.

Downloads

Published

2020-05-27

Issue

Section

Original Research Articles