Pattern and determinants of mortality among eclamptic women that presented in the Federal Teaching Hospital Abakaliki, Southeast, Nigeria

Abstract

Background: Eclampsia is a life-threatening obstetric emergency and one of the major causes of preventable maternal and perinatal mortality worldwide. Some women suffered eclampsia and died, while some live to tell their stories; what determines who dies? Aims: To determine the pattern and determinants of mortality among eclamptic women in our institution. Materials and Methods: This was a 5-year retrospective study of eclampsia managed between 1st January 2012 and 31st December 2016. Results: From this study, the incidence of eclampsia was 13.3 per 1000 deliveries and it contributes 21.1% of the maternal death and fetal case fatality rate of 30.2%. Women between the age range of 20–24 years accounted for majority (33.3%) of cases of eclampsia. The modal parity was Para 0 (50%) and most (89.6%) were unbooked. Antepartum eclampsia (53.1%) was the commonest form of eclampsia. Vaginal delivery was the commonest route of delivery. The determinants of maternal death were late presentation (>24 hours) (x2 = 15.37, P < 0.001), unconsciousness (x2 = 7.35, P < 0.01), severe blood pressure (x2 = 8.42, P < 0.01), and fetal death (x2 = 8.71, P < 0.01), while antepartum eclampsia (x2 = 6.23, P = 0.04), late presentation (>24 hours) (x2 = 16.76, P < 0.001), vaginal delivery (x2 = 4.82, P = 0.03), and maternal death (x2 = 12.00 P < 0.001) were determinants of fetal demise. Conclusion: Eclampsia is still a huge burden in our environment affecting maternal and perinatal morbidity and mortality profile. Early presentation and adequate treatment can help to reduce the incidence of this preventable obstetric disaster in our environment.