Lessons Learned in the Management of Eclampsia: A Retrospective Observational Study in Pregnant Women

Background Eclampsia is a critical obstetric emergency associated with significant maternal and fetal mortality and morbidity. This retrospective observational study assesses the clinical characteristics, management strategies, and findings in eclamptic patients, emphasizing lessons learnt from treatment delays and therapeutic interventions. Aims The study aimed to determine perinatal outcomes in eclamptic women and to evaluate perinatal outcomes based on the interval between the initial convulsion and delivery, as well as the duration of treatment before delivery and delivery methods. Study setting and design Eclamptic women who met the inclusion criteria and were admitted from January 1, 2012, to December 31, 2024, to the labor ward at BLDE (DU) Shri B M Patil Medical College Hospital and Research Centre in Vijayapura, Karnataka, India, were included in this study. Investigation findings and medical data were gathered and assessed. Results The study included 192 pregnant women having eclampsia, all beyond 28 weeks of gestation, meeting specified inclusion and exclusion criteria. A total of 192 babies were delivered, with 58 perinatal deaths (30.2%) recorded. Obstetric analysis revealed that primigravida patients constituted the majority, reinforcing their higher risk profile. Perinatal mortality was raised in individuals with systolic blood pressure (BP) of ≥160mm Hg, diastolic of ≥110mm Hg, newborns of birth weight less than 2 kg, and urine albumin levels exceeding 2+. Perinatal mortality was comparatively low when provided within six hours of convulsion and starting medical care. The cesarean section rate was high, reflecting the need for rapid stabilization. Conclusion This study highlights that early and appropriate use of medical management coupled with decisive delivery planning results in high fetal viability and acceptable maternal outcomes. The predominance of primigravida and the high cesarean rates suggest that eclampsia management protocols require continuous refinement to improve response times and further enhance fetomaternal safety. Emphasis on early recognition and rapid intervention remains essential in reducing morbidity and mortality associated with this obstetric emergency.