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A one year review of eclampsia in an Ethiopian Tertiary Care Center (Saint Paul’s Hospital Millennium Medical College, SPHMMC)

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Published/Copyright: July 14, 2017
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 45 Issue 7

Abstract

Eclampsia remains one of the five major causes of maternal mortality in developing countries. Advances in diagnosis and management have led to a significant reduction in maternal mortality and morbidity from this disease in developed countries. In developing countries the incidence of maternal death attributed to eclampsia remains high and, in Ethiopia, maternal mortality from this complication has instead risen over the last decade. The purpose of this study was to review the incidence of eclampsia at the largest feto-maternal center in the country over 1 year in an attempt to determine what quality improvement measures are needed and could realistically be implemented within the system to decrease this complication. There were a total of 104 eclamptic patients during the study period. The hospital incidence of eclampsia was 82/10,000 deliveries excluding those arriving to the hospital in the postpartum period (28 cases). There were eight maternal deaths making the case fatality rate one in 13 cases. The median convulsion to arrival time, referral to arrival time and magnesium sulphate administration time were found to be 3, 2 and 3 h, respectively. The probability of multiple seizures (≥3 episodes) was increased significantly with the prolongation of these time variables. Occurrence of multiple seizures was in turn significantly associated with adverse maternal outcomes (ICU admission, morbidities and mortalities). As expected, there was a high incidence of eclampsia and eclampsia related maternal death in the hospital. We recommend a thorough assessment of the referral system, upgrading and capacity building of more health facilities, organizing trainings and drills in health facilities; and availing magnesium sulphate in all health centers among others.

Keywords: Eclampsia; ICU admission; maternal morbidity; maternal mortality; seizure in pregnancy; standard of care
Corresponding author: Dr. Thomas Mekuria, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

  1. Author’s statement

  2. Conflict of interest: Authors state no conflict of interest.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

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Received: 2017-4-10
Accepted: 2017-5-26
Published Online: 2017-7-14
Published in Print: 2017-10-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Preeclampsia and intrauterine growth restriction: placental disorders still not fully understood
  4. Review article
  5. Hepar uterinum: a history of ideas on fetal nutrition
  6. Original articles
  7. Twin pregnancy in women above the age of 45 years: maternal and neonatal outcomes
  8. Maternal endothelial damage as a disorder shared by early preeclampsia, late preeclampsia and intrauterine growth restriction
  9. Maternal venous SHARP1 levels in preeclampsia
  10. Second-trimester maternal serum markers in the prediction of preeclampsia
  11. Pregnancy outcomes regarding maternal serum AFP value in second trimester screening
  12. Quantification of mechanical dyssynchrony in growth restricted fetuses and normal controls using speckle tracking echocardiography (STE)
  13. Serum cholesterol acceptor capacity in intrauterine growth restricted fetuses
  14. Antithrombin improves the maternal and neonatal outcomes but not the angiogenic factors in extremely growth-restricted fetuses at <28 weeks of gestation
  15. Simple approach based on maternal characteristics and mean arterial pressure for the prediction of preeclampsia in the first trimester of pregnancy
  16. Fetal death: an extreme manifestation of maternal anti-fetal rejection
  17. Intrauterine growth restriction and placental gene expression in severe preeclampsia, comparing early-onset and late-onset forms
  18. The relationship between maternal and umbilical cord adropin levels with the presence and severity of preeclampsia
  19. Expression of placental regulatory genes is associated with fetal growth
  20. Circulating soluble fms-like tyrosine kinase-1 and placental growth factor from 10 to 40 weeks’ pregnancy in normotensive women
  21. A one year review of eclampsia in an Ethiopian Tertiary Care Center (Saint Paul’s Hospital Millennium Medical College, SPHMMC)
  22. Congress Calendar
  23. Congress Calendar
https://doi.org/10.1515/jpm-2017-0118
Keywords for this article
Eclampsia; ICU admission; maternal morbidity; maternal mortality; seizure in pregnancy; standard of care

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Preeclampsia and intrauterine growth restriction: placental disorders still not fully understood
  4. Review article
  5. Hepar uterinum: a history of ideas on fetal nutrition
  6. Original articles
  7. Twin pregnancy in women above the age of 45 years: maternal and neonatal outcomes
  8. Maternal endothelial damage as a disorder shared by early preeclampsia, late preeclampsia and intrauterine growth restriction
  9. Maternal venous SHARP1 levels in preeclampsia
  10. Second-trimester maternal serum markers in the prediction of preeclampsia
  11. Pregnancy outcomes regarding maternal serum AFP value in second trimester screening
  12. Quantification of mechanical dyssynchrony in growth restricted fetuses and normal controls using speckle tracking echocardiography (STE)
  13. Serum cholesterol acceptor capacity in intrauterine growth restricted fetuses
  14. Antithrombin improves the maternal and neonatal outcomes but not the angiogenic factors in extremely growth-restricted fetuses at <28 weeks of gestation
  15. Simple approach based on maternal characteristics and mean arterial pressure for the prediction of preeclampsia in the first trimester of pregnancy
  16. Fetal death: an extreme manifestation of maternal anti-fetal rejection
  17. Intrauterine growth restriction and placental gene expression in severe preeclampsia, comparing early-onset and late-onset forms
  18. The relationship between maternal and umbilical cord adropin levels with the presence and severity of preeclampsia
  19. Expression of placental regulatory genes is associated with fetal growth
  20. Circulating soluble fms-like tyrosine kinase-1 and placental growth factor from 10 to 40 weeks’ pregnancy in normotensive women
  21. A one year review of eclampsia in an Ethiopian Tertiary Care Center (Saint Paul’s Hospital Millennium Medical College, SPHMMC)
  22. Congress Calendar
  23. Congress Calendar
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