Presentation and outcome of eclampsia at a Nigerian university hospital

To review the presentation of eclampsia and its outcome on the mother and babies in our environment with a view to suggesting strategies for improvement.

A retrospective study at 93 cases of eclampsia treated at Olabisi Onabanjo University Teaching Hospital Sagamu was undertaken. Data was collected by scrutinizing the case files collected from the medical records library after collecting their numbers from the labour ward register.

There were 93 cases of eclampsia out of a total delivery of 5423 giving an incidence of 1.7 percent. Almost all the patients (96.8%) were unbooked. Antepartum eclampsia constituted 93.5 percent of cases. Nulliparous teenagers were the most commonly affected with a relative risk of 25 when compared with multips. Caesarean delivery was more common than vaginal delivery in the ratio 6:4. There were 19 maternal deaths, a case fatality rate of 20.0 percent and this was not related to the mode of delivery. (RR 1- 1.1). The perinatal mortality was significantly less with caesarean delivery (RR 1:0.38).

Eclampsia, occurring mainly in unbooked patients is still one of the major causes of maternal mortality and good antenatal care will significantly reduce the incidence and improve the outcome especially in teenage nullipara who are mostly susceptible.