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Presentation and management of eclampsia.

J C Konje1, K A Obisesan, O A Odukoya

  • 1Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|May 1, 1992
PubMed
Summary

Eclampsia management in Nigeria showed high rates of seizures occurring outside the hospital. Comprehensive antenatal care and improved management are crucial for reducing maternal and perinatal mortality.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal Health
  • Neurology

Background:

  • Eclampsia remains a significant cause of maternal and perinatal morbidity and mortality globally.
  • Understanding the timing and location of seizures is critical for effective management strategies.

Purpose of the Study:

  • To analyze the management of eclampsia cases at a tertiary hospital in Nigeria.
  • To identify factors contributing to eclampsia and suggest strategies for prevention and improved outcomes.

Main Methods:

  • Retrospective analysis of 347 eclampsia cases managed between 1977 and 1986.
  • Data collection on seizure occurrence (antepartum, intrapartum, postpartum), management protocols, and mortality rates.

Main Results:

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  • Eclampsia occurred in 9.3 per 1000 deliveries.
  • Seizures predominantly occurred during labor (46.2%) and antepartum (31%). Only 5% of seizures initiated in the hospital.
  • Maternal mortality was 2.9% and perinatal mortality was 193 per 1000 deliveries.

Conclusions:

  • Comprehensive antenatal care is vital to prevent avoidable factors like poor care and prolonged labor, thereby reducing eclampsia incidence.
  • Improved pre-referral management, judicious use of anticonvulsants (magnesium sulfate or diazepam), and avoidance of specific intravenous fluids can decrease eclampsia-related morbidity and mortality.