Shaheen B, Hassan L, Obaid M.
Eclampsia, a major cause of Maternal and Perinatal Mortality: A prospective analysis at a tertiary care hospital of Peshawar.
J Pak Med Assoc Jan ;53(8):346-50.

Objective: To observe pregnancy outcome in eclamptics and to explore the avoidable factors contributing to the adverse outcome. Setting: Department of Obstetrics and Gynaecology. Hayatabad Medical Complex, Peshawar. Method: This prospective cross-sectional observational study (from 1 st Jan 2001 to 31 st Mar 2002) included all the patients admitted to the unit with eclampsia. A Sociodemographic and clinical data was collected along with the results of investigations to categorize the complications and data was analyzed using various statistical tests. Main outcome Measures: Maternal and Perinatal morbidity and mortality. Results: During the study period 71 patients developed eclampsia (frequency: 1.2%). Majority were unbooked (86%), primigravida (69%), < 25 years of age (63 %), referred from other health facilities (66.2%) and had some delay in seeking medical help (60%). Thirty five percent of patients developed major complications and 16.9% of them died ( 48% of overall maternal mortality). Mortality was frequent in Afghani women (OR 7.71 p value 0.002) and in women who sought medical help more than 6 hrs after developing seizures (OR 14.6 P value 0.0004). Perinatal mortality was 41.6% having prematurity the main risk factor (OR 13.33 p value 0.0000068). Conclusion: To decrease the adverse outcome associated with eclampsia a community-based approach is needed to improve community health education, socioeconomic status and prenatal care. Delivery of proper health care system and emergency obstetrical care facilities are vital for prevention, early detection, proper management and hence to save the mothers and their babies from such a dreadful disease (JPMA 53:346;2003).

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