Incidence and determinants of adverse outcomes among women who were managed for eclampsia in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Abstract

Background The incidence of eclampsia and its adverse maternal outcomes are very high in developing countries, particularly in Subsaharan African Countries. Identifying predictors for adverse maternal outcomes of eclampsia has paramount importance for helping health care providers to optimize their management outcomes. Therefore, this study aimed to assess the incidence of adverse maternal outcomes of eclampsia and its determinant factors. Methods A retrospective follow-up study design was applied. The data were extracted from patient charts using a structured, pre-tested, questionnaire. Descriptive analyses (frequencies, means, and standard deviation) were calculated, and bi-variable and multivariable logistic regression models were used to testing the association between independent variables and an outcome variable. After the data were coded and entered into Epi-Info Version 7.2 Software, the data were analyzed using STATA Version 14 Statistical Software. Results The magnitude of eclampsia was 5.36 per 1000 pregnancies (95% CI: 4.72, 6.10). The incidence of adverse maternal outcomes in eclamptic mothers was 53.7% (95% CI: 47.02, 60.24%). After adjusting for covariates maternal age 30–34, AOR 5.4 [95% CI = 1.02, 28.6]; age above 34, AOR 10.5 [95% CI = 1.3, 88.6]; gravidity 2–4, AOR 0.3 [95% CI = 0.1, 0.9]; 10 or more convulsions, AOR 4.6 [95% CI = 1.4, 14.9]; mild pyrexia, AOR 20.4 [95% CI = 3.7, 112.7]; moderate pyrexia, AOR 14.6 [95% CI = 1.7125.1]; platelet count below 50,000 cells/mm3, AOR 34.9 [95% CI = 3.6, 336.2]; platelet count between 50,000 and 99,000 cells/mm3, AOR 24.5 [95%CI = 5.4111.6]; and stillbirth of the current pregnancy, AOR 23.2 [95%CI = 2.1257.5] were strong predictors of adverse maternal outcomes in eclamptic mothers. Conclusions The incidence of adverse maternal outcomes of eclampsia was found to be high compared to similar studies discussed in this study. This study recommends early identification of patients with the risk factors (having many convulsions, high body temperature, low platelet count, patient age above 30 years, and 2–4 pregnancies), strengthening the referral system, and advocation of research on the area of adverse maternal outcomes and thereby encourage evidence-based medicine.

Eclampsia Managed at Nnamdi Azikiwe University Teaching Hospital (NAUTH), NNEWI, South-East Nigeria: A 5-Year Retrospective Cross-Sectional Studya

“…This is not unusual for a nation like Nigeria that has low and moderate income levels and antenatal care facilities that are inadequate. The majority of the women had antepartum eclampsia, which is consistent with findings from other studies conducted in this region of the world [10][11][12], but not with data from high-income nations where postpartum eclampsia is more typical [8]. Improvements in prenatal care, screening and early preeclampsia identification, and the preventive use of magnesium sulphate in the treatment of severe preeclampsia in high-income nations have all been credited with this [8].…”

“…Fetal bradycardia for about three to five minutes is a common finding during and immediately after the seizure. Resolution of maternal seizures activity is associated with fetal tachycardia and loss of heart rate variability, sometimes with transient decelerations [11]. The fetal heart rate pattern generally improves with maternal and fetal therapeutic interventions.…”

“…The fetal heart rate pattern generally improves with maternal and fetal therapeutic interventions. A non-reassuring pattern with frequent, recurrent decelerations for more than 10 to 15 minutes despite maternal and fetal resuscitative interventions suggests the possibility of an occult abruptio placenta [11].…”

Prevalence And Outcomes Of Eclampsia At Federal Teaching Hospital Gombe, Nigeria

“…Adverse outcomes, including death from Eclampsia, are more likely in women at the extreme of ages, early onset preeclampsia, medical co-morbidities, low platelet count, having 10 or more convulsions, fever and primigravidas. 7 The pathophysiology of eclampsia is unknown, but the leading theory is that the blood-brain barrier is disrupted by the passage of fluid, ions, and plasma protein into the brain parenchyma. 8 Massive cerebral edema, white matter hemorrhage, and necrosis are typical autopsy findings in eclampsia.…”