Diagnostic and Prognostic Epidemic Aspect of Eclampsia at the Kolda Regional Hospital Center (Senegal)

Abstract

Objectives: To evaluate the epidemiology of eclampsia, to assess maternal and perinatal prognosis and management. Material and method: This was a retrospective, descriptive study from January 1, 2015 to December 31, 2018. Included were all women received in the emergency department of our health facility for generalized seizures and/or disturbances of consciousness, occurring between the 20th Week of Amenorrhea (WA) and the 6th week of postpartum on a field of hypertension. The sources of the data consisted of antenatal consultation cards, delivery records, hospital records, operating theater and resuscitation records. The variables studied were sociodemographic characteristics, the course of pregnancy, childbirth and neonatal parameters. Data were captured and analyzed using SPSS 11.0 software. Results: The study focused on 190 cases with a prevalence of 3.5%. The average age of the patients was 20 years with extremes of 14 and 40 years. The average parity was 4.1 deliveries with extremes of 1 and 7. Nearly three-quarters of the patients (74.7%) of the patients were primiparous. Almost all the patients were evacuated. More than half of the seizures (53.1%) were recorded before work and more than one out of two patients had two seizures. Caesarean section was the mode of delivery in more than one out of two patients (56.8%). Maternal complications were marked by renal failure (23 cases), the HELLP syndrome (72 cases), and the retro placental hematoma (83 cases). The fetal impact was marked by prematurity in 90% of cases and 17 cases of fetal death in-utero. Nineteen maternal deaths were recorded while early neonatal mortality was 437 per 1000 live births. The average hospital stay of the survivors was 6.2 days. Conclusion: Eclampsia is still common in our regions. It occurs preferentially in young primiparas with hypertension and/or proteinuria on a poorly followed pregnancy. Magnesium sulphate and cesarean section can improve the maternal and fetal prognosis. Prevention necessarily means quality prenatal care.