Sipra Singh 1 , Smita Kumari 2 , Shanti Singh
BACKGROUND Pre-Eclampsia and Eclampsia are the leading causes of maternal and perinatal morbidity and mortality worldwide. In developed countries, much lower incidences have been achieved through aggressive screening and management of Pre-Eclampsia. In developing countries like India, there is a wide gap in quality of health care in cities and rural area. The present study was done to evaluate the incidence of hypertensive disorders and maternal and fetal outcome in a tertiary care centre catering to poor people of Bihar, Bengal and neighboring country, Nepal. MATERIALS AND METHODS This is an observational descriptive study. After obtaining institutional ethical committee approval and informed consent from patients, all the patients presenting to our institution for delivery with Pre-Eclampsia and Eclampsia were included in the study. Socio-economic status, frequency of ANC, age, parity and period of gestation were recorded. Investigations included complete blood count, urinary protein, coagulation profile, liver function tests and kidney function tests. Mode of conduct of delivery and maternal and fetal outcome were thoroughly recorded and described. Data was presented in the form of n (%). RESULTS 64.28% cases with Pre-Eclampsia and 95.12% cases with Eclampsia were from low socio-economic status. 95.12% cases with Eclampsia and 67.5% cases with Pre-Eclampsia had no ANC throughout the pregnancy. Most of the patients were in the age group of 20-25 years. 86.11% cases with Eclampsia and 66.68% with Pre-Eclampsia were primigravida. Most of the patients presented with 37 weeks of gestation. 54.76% Pre-Eclampsia cases and 58.94% Eclampsia delivered by L.S.C.S. Pulmonary edema and acute renal failure were the most common complications. Maternal mortality was 25.60% in Eclampsia cases. The most common cause of maternal mortality was pulmonary edema. Incidence of IUD+ stillbirth was 16.66% in Pre-Eclampsia cases and 34.14% in Eclampsia cases. Overall perinatal mortality was 28.57% in Pre-Eclampsia cases and 52.84% in Eclampsia cases. The most common cause of fetal mortality was Asphyxia. DISCUSSION Incidence of Eclampsia was high because of lack of awareness regarding antenatal check up. Period of gestation was >37 weeks and due to infrequent ANCs, diseases remained unrecognized and patients came to the hospital only after onset of labor pain or even trial of labor by untrained dais and quacks at home. Due to late detection of cases, maternal and fetal outcome was very poor. CONCLUSION There is a lack of awareness about significance of regular ANC and Pre-Eclampsia and Eclampsia are usually recognized late, mostly when they have already developed complications. Maternal and fetal outcome is still very poor in rural areas of the country.
