Maternal outcome in eclamptic patients in Abuja, Nigeria--a 5 year review
1Department of Obstetrics and Gynaecology, National Hospital Abuja, Nigeria. efenae@yahoo.com
Objective:
To assess the outcome ofwomen admitted with eclampsia in the National Hospital, Abuja, Nigeria.
Study Design/Setting:
A retrospective analysis. The medical records register in the accident and emergency department, labour ward, maternity ward and the intensive care unit were searched to identify cases of eclampsia admitted at the National Hospital,Abuja (NHA) between 1st March 2000 and 28th February 2005.
Results:
The incidence of eclampsia was 7.8 per 1000 deliveries. Eclampsia significantly occured in nulliparous and unbooked mothers (p < 0.001 & p < 0.0001 respectively). Most (71.5%) of mothers delivered by Caesarean section and the most common indication for this was an unfavourable cervix (cervix thick, firm and closed when assessed at presentation in the labour ward). Nineteen (41.3%) of mothers developed complications with HELLP (hemolysis, elevated liver enzymes, low platelets) occurring in six patients (31.6%). There were 13 maternal deaths giving a case fatality rate of 28.3% and a maternal mortality ratio for eclampsia of222/100,000. HELLP syndrome was responsible for 46.2% of deaths in the study.
Conclusion:
The maternal outcome of eclamptics in Abuja, Nigeria is poor and HELLP syndrome is a major contributor to the high fatality rate. Emphasis should be on primary preventive measures such as early, continuous, good antenatal care and improvement of intensive care facilities. More widespread use of Magnesium sulphate for anticonvulsant prophylaxis is advocated.