A comparative study of antepartum and postpartum eclampsia at a tertiary care centre

Abstract

Background: Hypertensive disorders complicate 5 to 10 percent of all pregnancies. Eclampsia is one of the dreaded complications of preeclampsia and remains one of the leading causes of maternal deaths in our country. The incidence of post-partum eclampsia is on the rise. Our aim was to study the incidence, demographical factors, and clinical profile associated complications, perinatal and maternal outcomes in pregnancies complicated with antepartum and postpartum eclampsia and compare between the two groups. Methods: A prospective study was done of all pregnancies complicated with antepartum and postpartum eclampsia over a 10 month period from January 2014 to October 2014 managed at Karnataka institute of medical sciences, Hubli. The results were tabulated and analyzed. Results: Incidence of antepartum eclampsia was 1.19% and postpartum eclampsia 0.31% amongst the patients delivered in Karnataka institute of medical science, Hubli. Average age of the patients was 24.1 years in the antepartum group and 22.7 yrs in postpartum group. Both antepartum and postpartum eclampsia was most commonly seen in primi gravidas. Though both the types of eclampsias were most commonly seen in term patients, preterm patients had a higher incidence of postpartum eclampsia. Majority of the patients of antepartum eclampsia had mild hypertension whereas postpartum eclampsia patients had mostly severe hypertension. Headache was the most common prodormal symptom in both groups. Neonatal mortality was higher in the postpartum group (44%), whereas maternal mortality was higher in the antepartum group (16.1%). Conclusions: Incidence of eclampsia cases is high in tertiary care centres. Eclampsia is still one of the leading causes of maternal deaths in our country. Maternal and periantal mortality is high in both antepartum and postpartum eclampsia cases.  The incidence of postpartum eclampsia is significant. Patients with preeclampsia and eclampsia should be closely monitored post natally and measures should be taken to prevent postpartum eclampsias.