Eclampsia Managed at Nnamdi Azikiwe University Teaching Hospital (NAUTH), NNEWI, South-East Nigeria: A 5-Year Retrospective Cross-Sectional Studya

Abstract

Background: Obstetric emergencies like eclampsia continue to be a leading cause of morbidity and mortality in pregnant women and fetuses in modern society. Given its detrimental consequences on the pregnant woman, her unborn child, and any later medical difficulties linked to this illness, it has remained to be a cause of concern for obstetricians, especially in low-and middle-income countries. Hence the requirement for periodic review in our environment. Objectives: The objective of this study is to determine the prevalence, pattern of presentation as well as fetal and maternal outcome of cases of eclampsia with a view to suggest interventions to reduce the incidence and associated morbidity and mortality associated with eclampsia. Materials and Methods: This study examines all eclampsia cases treated at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria between January 1, 2017, and December 31, 2021. The hospital’s medical records division provided access to the case notes of every eclampsia patient. The socio-demographic and clinical data of the subjects were gathered using a systematic proforma, and they were then evaluated and analysed. The teaching hospital’s ethics committee was contacted in order to request and get ethical clearance and permission. The statistical software for social sciences (SPSS) version 25 was used to analyse the data. Results: The eclampsia prevalence rate observed was 1.65%. The ages of the women ranged from 18 to 41 years with mean age and standard deviation given as 26.97 ± 4.61 years. The majority 41 (95%) of the pregnant women were unbooked, and about 50% of the women presented at gestational ages of 28-33weeks. Antepartum eclampsia identified as the most common clinical type occurring in 38 (63.3%) of cases and headache was the most common prodromal symptom associated with eclampsia. Majority (86.7%) of the eclamptic women had ceaserean section as their mode of delivery. There were 4 (6.7%) maternal deaths within the study period from eclampsia and 11 (18.3%) of the women had Acute kidney injury among other complications. Twenty-eight women (46.7%) delivered babies that had birth asphyxia and 24(40%) of the babies required admission into the special care baby unit (SCBU). Four (6.7%) of the babies of women with eclampsia during the study period died within the neonatal period. Conclusion: Eclampsia is a leading cause of maternal and perinatal morbidity and mortality especially in developing countries like Nigeria. Therefore, Women should be adequately counseled on preconception care, early booking and regular antenatal care visits, with proper monitoring and control of blood pressure, to enable early detection and effective management to mitigate the associated feto-maternal complications of eclampsia. Prompt diagnosis and management of hypertensive disorders are key in preventing the maternal and perinatal morbidity and mortality that are associated with these disorders.