Comprehensive analysis of eclampsia: Risk factors, complications, interventions, and feto-maternal outcomes

Abstract

Background: Eclampsia, a severe complication of preeclampsia, remains a significant cause of maternal and perinatal mortality, especially in low-resource settings. Characterized by convulsive seizures, eclampsia can lead to severe maternal complications such as HELLP syndrome, placental abruption, and postpartum hemorrhage, as well as adverse neonatal outcomes like prematurity, low birth weight, and neonatal death. This study aimed to assess the risk factors, treatment strategies, and maternal-fetal outcomes associated with eclampsia in a tertiary care setting. Materials and Methods: A retrospective study was conducted at Sapthagiri Hospital in Bengaluru, India, covering cases from January 2021 to June 2024. Data were collected from medical records of pregnant women diagnosed with eclampsia. Variables analyzed included maternal age, BMI, parity, gestational age, blood pressure, proteinuria, and seizure activity. Outcomes were analyzed using SPSS, focusing on maternal complications and neonatal outcomes. Results: Among 5,403 deliveries, 34 (0.62%) cases of eclampsia were identified. The majority of patients were aged 24-29 years (52.9%) and had a normal BMI (70.6%). Primiparous women constituted 64.7% of the cases. Severe maternal complications included postpartum hemorrhage (70.6%), partial HELLP syndrome (32.4%), and placental abruption (47.1%), with a maternal mortality rate of 2.9%. Neonatal outcomes were concerning, with 62.9% of infants born preterm, 64.9% with low birth weight, and a perinatal mortality rate of 10.8%. Cesarean sections were performed in 85.3% of cases, highlighting the need for rapid intervention. Conclusion: Eclampsia predominantly affected young, primiparous women with normal BMI, leading to significant maternal and neonatal morbidity and mortality. The findings underscore the importance of early identification and management of eclampsia to improve maternal and neonatal outcomes. Vigilant monitoring and timely intervention, including the use of magnesium sulfate and antihypertensives, are critical in mitigating the severe impacts of this condition.