A prospective study of risk factors of mortality in patients with eclampsia: a single center study

Objectives: To determine the risk factors affecting the mortality rate in women with eclampsia. Methods: This prospective observational cohort included 200 patients who presented with seizures or coma (eclampsia) which could not be attributed to other causes and admitted in the emergency (labour room). The clinical, obstetric examination, and examination pertinent to the signs and symptoms of hypertension and low haemoglobin were done. Laboratory investigations were performed. The fetomaternal outcomes were determined in terms of mortality, mode of delivery, and birth weight. Association of risk of mortality was evaluated in terms of demographic characteristics, obstetric history, delivery details, and signs, symptoms and investigations. P-value <0.05 was considered statistically significant. Results: Maternal death occurred in 37 (18.50%) patients. In 29.73% of patients, cause of maternal death was acute pulmonary edema followed by DIC (13.51%). Socioeconomically, low class status, illiteracy, and rural residence carried significantly higher odds of mortality with odds ratio of 1.27, 14.729, and 3.218, respectively. Compared to survivors, those who died had significantly more undelivered pregnancies (40.54% vs. 0%, P<.0001); significantly more instrumental delivery (13.64% vs. 2.45%), and significantly more preterms (54.55% vs. 33.13%). Conclusion: In developing countries, eclampsia holds a significant association with maternal deaths, institutional deliveries, and preterm birth. Appropriate caution and management should be done for eclamptic patients to decrease the mortality and improve the fetomaternal outcomes.