Maternal Mortality in EcLampsia in the Guinea Savannah Region of Nigeria

Abstract

Eclampsia is still very prevalent in Northern Nigeria, constituting the third commonest cause of maternal deaths with a mortality rate of 9-10% annually. In order to identify some factors that may be associated with maternal deaths in eclamnsia in this region, nine deaths that occurcd during a qrospective study of 100 eclamptics in 1979 were reviewed. It was discovered that maternal death occured twice more commonly in the under 16 and rarely in mothers over 20 years of age. There was an almost two fold mortality rate among multinarous patients implying that eclampsia occurs in this grouo in the nresence oi some other underlying medical condition. Intrapartum eclamnsia (mortality rate of 11. 1%) was more lethal than antepartum (6.8%) and nost nartum (5.8%) ones. There was no correlation between degree of hypertension or number of fits and maternal mortality, though there was slight rise when the diastolic pressure was higher than llOmmHg at the time of fits. Abdominal delivery was associated with a lower mortality (3.1%) than vaginal delivery (10.4%). Mortality rose ten fold if eclamnsia was associated with sepsis. It was concluded that lethal factors in eclampsia in this environment differed some what from those in more industrialised communities; early marriage, intrapartum fits and sepsis playing significant roles.