ECLAMPSIA;

Trends in maternal morbidities and mortalities. “A review of neglected parameters in developing countries”.

Abstract

Introduction: Hypertensive disorders during the pregnancy are seen in 5- 8% of cases. The worst form is eclampsia,
associated with fits or convulsions. It is a rare event in developed countries. Eclampsia can not only lead to maternal mortalities but also
cause maternal morbidities. Lot of studies have been done about different aspects of this disease. This study aims to see the maternal
morbidities, mortalities but also to dig down the underlying parameters, which are responsible for them. They include Personal, Social,
Educational, Medical and National problems. Objectives: (1) To compare the Fetomaternal outcome and complication in low risk and
eclamptic patients. (2) To find out the underlying parameters or variables associated with this catastrophy. Study design: It is a
Descriptive Study. Settings: Lady Aitchinson Hospital, Obstetrics/Gynecology Unit 1, Lahore, Pakistan. It is a teaching, tertiary care
centre affiliated with King Edward Medical University which is a well known all over the Asia. Duration: 1st Jan 2008 to 31st Dec 2010.
Subjects and methods: 10557 patients presented in emergency room for Obstetrical causes.1200 patients had one or the other form of
hypertensive disorders.400 patients with Eclampsia presented with hypertension, fits and generalized body swelling. The patients who
fulfilled the inclusion criteria were included in the study. Results: According to the results it is seen that maternal mortality is higher in
Eclampsia as compared to low risk (p=0.01)The maternal morbidities are also higher than normal low risk population (p=0.011).
Perinatal outcome is again better in low risk than high risk group (p=0.099) .It was observed that illiteracy, poor socioeconomic status
,lack of awareness about health facilities, poor arrangement at Basic Health units of villages, delayed decision making, delay in referral
and management are the underlying variables and pitfalls which have to be addressed. Conclusions: It is concluded from this study that
although Eclampsia is a major killer and an uphill battle, but the measures can be taken at missed & neglected parameters, responsible for
the condition, to reduce the maternal morbidity and morality.