Comparison of Outcome of Eclamptic Patient Following Vaginal Delivery versus Caeserian Delivery by Spinal Anaesthesia

Eclampsia is a common problem in pregnancy in Bangladesh. It is a severe form of preeclampsia which affects 5 to 7% of pregnancies is a significant cause of maternal & neonatal morbidity & mortality. Pre-eclampsia when complicated with generalized tonic-clonic convulsions and/or coma is called eclampsia. The term eclampsia is derived from a Greek word, meaning "like a flash of lightening". It may occur quite abruptly, without any warning manifestations. Eclampsia is a major cause of maternal mortality & morbidity as well as foetal loss worldwide, particularly in the third world. Appropriate measures & effective treatment of eclamptic patient in proper time reduce maternal mortality & morbidity. The mainstay of treatment of eclampsia is delivery of the foetus. Two methods are usually applied for delivery of foetus in eclampsia i.e. vaginal delivery & caesarean delivery. This study was done in the department of Gynae & Obs and department of Anaesthesiology, Mymensingh Medical College Hospital from 1st January 2016 to 30th June 2016 to observe the incidence, complications (morbidity) & mortality of eclamptic patients & which method (vaginal delivery versus caesarean delivery by spinal anaesthesia) is safe, better for the eclamptic patients as well as foetal mortality. Successful vaginal delivery is dependant on complex interactions of three variables (3 P) that is power (uterine contraction), passenger (foetus) & passage (birth canal) but power is less effective in eclamptic patient than normal partuents. Vaginal delivery requires prolong times compared with cesarean delivery. Anaesthetic technique is also an important factor for maternal mortality & morbidity of caesarean delivery. Spinal anaesthesia is widely regarded as a reasonable anaesthetic option for caesarean delivery in eclamptic patients. Currently the safety of spinal anaesthesia is well established and it can provide better obstetrical outcome when chosen properly. In this observation caesarean delivery by spinal anesthesia is safer, less complications, less maternal & neonatal mortality than vaginal delivery in eclamptic patients.