A Review of Pregnancy Outcome in Women with Eclampsia at the University of Calabar Teaching Hospital, Calabar
AbstractContext: Eclampsia remains an important cause of maternal and perinatal morbidity and mortality throughout the world, particularly in developing countries. A constant review of treatment outcomes is therefore needed.
Objective: To document the relative risk of adverse pregnancy outcome in eclamptic women who delivered in our hospital (vaginal vs. abdominal) and to proffer measures for risk-reduction.
Study Design, Setting and Subjects: A comparative review of pregnancy outcome in women with eclampsia at the University of Calabar Teaching Hospital (UCTH), Calabar, over a 10-year period was conducted. Eighteen women who had abdominal delivery were compared with a control group of 11 who had vaginal delivery. Six women who had regional anaesthesia for abdominal delivery were compared with a control group of 12 cases that underwent general anaesthesia.
Outcome Measures: Adverse maternal outcome including maternal death; adverse fetal outcome.
Results: The relative risk (RR) of adverse fetal outcome with abdominal delivery was higher for parameters such as birth asphyxia (RR: 2.42), low birth weight (RR: 1.84) and neonatal death (RR: 1.22). The risk for adverse maternal outcome with abdominal delivery was also higher: hemiplegia (RR: 1.22), oliguria (RR: 1.84) and maternal death (RR: 1.22). The use of regional anaesthesia for abdominal delivery was associated with a risk of failed anaesthetic technique (RR: 2.00) and aspiration of gastric contents (RR: 1.20).
Conclusion: Eclampsia is a serious but preventable obstetric complication associated with poor pregnancy outcome. Current treatment protocol in our hospital has not resulted in improved outcome, especially in eclamptics delivered by caesarean section.
(Tropical Journal of Obstetrics and Gynaecology: 2001, 18(2): 66-68)
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