https://orcid.org/0000-0002-6136-8998
Abstract
Background
Eclamptic disorder during pregnancy is one of the common problems in sub-Saharan countries and forms one of the deadly triads along with hemorrhage and infection which complicates feto-maternal outcomes of pregnancy. So, the purpose of this study was to assess the prevalence of eclampsia and its maternal and fetal outcome in Gandhi Memorial Hospital, Addis Ababa Ethiopia, 2019.
Methods
A descriptive retrospective cross-sectional study was employed on a review of all cases of women who were delivered at Gandhi memorial Hospital from 1st of September 2017 to –last of August 2018. Data were analyzed using SPSS version 25 software. Descriptive statistics were used to calculate frequencies and percentages and data was presented using texts and, tables.
Results
Out of the total deliveries, the prevalence of eclampsia was found to be 6.2%. In our experience of a very high rate of eclampsia, fortunately, we had only 3 maternal deaths out of the total cases. However, neonatal mortality and stillbirths had been extremely high: 41 (22.1%) of stillbirths and 30.3% neonatal deaths (a total burden of 52.4% of perinatal mortality). About 70.8% had reported a history of prior pregnancy-induced hypertension and 73.5% induced their current pregnancy following eclampsia. From mothers who required interventions to terminate the pregnancy by induction, 47.8% ended by cesarean section secondary to non-reassuring fetal status (29.2%). The majority (91.9%) had taken magnesium sulfate for the management of convulsion and 86.5% had taken hydralazine for hypertension management. Abruption of the placenta (96.2%), postpartum-hemorrhage (89.2%), and HELLP syndrome (83.8%) were major maternal adverse outcomes reported, and 22.1% of pregnancy was ended as stillbirth. Over 53.6% of delivered babies, 18.4% of neonates required admission to nursery/NICU referral.
Conclusion
The prevalence of eclampsia was relatively high, with corresponding high maternal and perinatal morbidity and mortality. Increasing early detection before pregnancy, antenatal screening, and the use of magnesium sulfate to control convulsions will reduce the disorder and associated morbidity and mortality for both mother and fetus.
Abbreviations
HELLP, hemolysis, elevated liver enzyme levels, and low platelet levels; DIC, disseminated intravascular coagulation; SNNPR, Southern Nations, Nationalities and People’s Region; IUGR, intra-uterine growth retardation; ICU, intensive care unit; C/S, cesarean-section.
Data Sharing Statement
The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request and data request may be made and imposed on the corresponding author, email: [email protected].
Ethics Approval and Consent to Participate
Ethical clearance was obtained from Addis Ababa University. All data were fully anonymized before data was accessed. Personal client information was not recorded, and after finishing the data collection the patients’ document return to the card room, the information was used for study purposes only.
Acknowledgments
We would like to express our deepest heartfelt thanks to Addis Ababa University for allowing conduct this study. Our special thanks go to Gandhi Memorial Hospital staff for their support during the data collection process.
Authors Contributions
AY-was involved in the conception, design, analysis, interpretation, report, manuscript writing, design, analysis, interpretation, and report writing. WA- was involved in the design, analysis, and interpretation of the data. All authors read and approved the final manuscript. All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.