Saudi Journal of Medical and Pharmaceutical Sciences (SJMPS)
Volume-6 | Issue-09 | 616-621
Original Research Article
Anesthesia-Resuscitation and Prognostic Factors of Morbidity and Mortality of Eclampsia: A Study in Cumilla Medical College, Cumilla, Bangladesh
Md. Kamrul Hossain, Md. Delwar Hossain, Mohammad Shakhawat Hossain, Md. Atower Rahman
Published : Sept. 30, 2020
Abstract
Introduction: Eclampsia, a major neurological complication of pre-eclampsia, is defined by a convulsive manifestation and /or consciousness disorder occurring in a preeclampsia context and cannot be attributed to a pre-existing neurological problem. Pre eclampsia is a leading cause of maternal morbidity and mortality. Substandard care is often present and many deaths are preventable. The severity of this pathology is correlated with visceral neurological, renal, hepatic and / or hematological involvement. Objective: To study the peculiarities of anesthesia-resuscitation and the prognostic factors of morbidity and mortality of eclampsia in the intensive care unit of the Anaesthesiology Dept. Cumilla Medical College, Cumilla, Bangladesh. Materials and Methods: All patients admitted to resuscitation for management of eclampsia from 1 January to 31 December 2018 were included. We studied the clinical, therapeutic, evolutionary and prognostic factors of morbidity and mortality. Results: We collected 51 cases of eclampsia for 5000 deliveries in the study (incidence of 1%). The average age of the patients was 22.23 years. Primiparity was found in 28 patients (54.9%). Antenatal consultations were effective in 4 patients (7.8%). Consciousness was clear at admission in 42 patients (82.36%) and for one patient a Glasgow score < 8 was reported (1.96%). Severe hypertension was observed in 27.4% of cases. A ventilation intubation of 03 days was required in one patient in 1.9% of cases. Caesarean was the mode of delivery in 56.8% of cases and vaginal delivery was performed in 43% of cases. General anesthesia was doing in 20 patients (68.9%) and spinal anesthesia was performed in 9 patients (31%). Maternal complications were represented by: Postpartum acute renal failure (13.7%), Hellp syndrome (11.7%), and coagulopathy (15.6%). Prematurity was found in 14 neonates (13.7%), perinatal mortality was 9.8% and the maternal mortality rate was 5.8%. Conclusion: Eclampsia is still responsible for high maternal and infant mortality. The association of two or even more serious factors is very important in this mortality.