Fetomaternal outcome in eclampsia.

Abstract

A cross-sectional hospital based study was conducted to analyze the relation of fetomaternal outcome with the time interval between onset of fit to delivery and onset of fit to start of anticonvulsant, in eclampsia patients, from April 2001 to October 2002 in the department of Obstetrics and Gynecology, B. P. Koirala Institue of Health Sciences (BPKIHS), Dharan. Of the 56 total cases, 22 (39.2%) patients reached the health facility within 3 hours of the onset of fits, and 5 (8.9%) after 12 hours. Twenty-five patients (44.6%) were first managed in different health care centers while 31 (55.4%) came directly to BPKIHS, Dharan. Maternal complications occurred more frequently in those with fit to delivery time interval and fit to start of anticonvulsant time interval of more than 12 hours. Diazepam was the main anticonvulsant used in other health service facilities while in BPKIHS, 32 (57.1%) patients were given magnesium sulphate and 24 (42.9%) phenytoin. There were 2 maternal deaths, which occurred in patients in whom the time interval between the onset of fit to delivery and the start of anticonvulsant was more than 24 hours. Seven patients presented with intrauterine fetal deaths and there were 2 neonatal deaths. Eclampsia is associated with poor fetomaternal outcome. The fetomaternal complications are increased when the fit to delivery time interval and fit to start of anticonvulsant time interval is prolonged. Rational use of appropriate anticonvulsants along with safe delivery should be promoted for eclampsia patients. Key Words: Eclampsia, fetomaternal outcome.