Saima Aziz Siddiqui, Nargis Soomro.
Eclampsia; depicting a challenge of unmet need for prenatal care.
Med Channel Jan ;16(2):244-8.

OBJECTIVE: To describe the frequency of eclampsia, HELLP syndrome in eclampsia & fetomaternal outcome of eclampsia with the use of magnesium sulphate, in patients presenting at gynaecology unit II of Civil hospital Karachi. DESIGN: Cross sectional study PLACE & DURATION OF STUDY: Gynaecolgy Unit II, Civil Hospital Karachi. January to december 2009. METHODS: All consecutive women with the diagnosis of eclampsia during the study period were included. Patients with epilepsy & fits due to other causes were excluded. Eclampsia was defined as generalized tonic clonic convulsions in the absence of neurological, metabolic or other organic cause, occurring after 20 weeks of pregnancy upto 10 days postpartum. Data was collected through a semistructured proforma & details of age, parity, gestation, type of eclampsia, maternal, fetal& neonatal complications were noted. Maternal outcome measures were surgical intensive care admission, HELLP syndrome, renal failure, isolated thrombocytopenia, pulmonary oedema, cardiac failure & death, whereas fetal outcome measures were live births, still births, neonatal deaths, neonatal intensive care admission, preterm births & intrauterine growth restriction(IUGR). RESULTS: Frequency of eclampsia was 17.16/1000 deliveries. Antepartum eclampsia was 49.1% followed by intrapartum eclampsia 28.3% & postpartum eclampsia 22.6%. Frequency of HELLP syndrome in eclampsia was 18.86%. Case fatality rate was 1.88%, whereas 60.37% patients needed intensive care admission. Perinatal mortality rate was 37.5%. Preterm birth rate was 50.0%.IUGR was found in 28.57% cases. CONCLUSION: Eclampsia is still a major obstetric complication & is associated with high rates of HELLP syndrome.

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