Maternal and Perinatal Outcomes of Eclampsia in a Tertiary Health Facility in Southwestern Nigeria

Abstract

Background: Globally, eclampsia is a life-threatening emergency that majorly contributes to maternal and perinatal morbidity and mortality. It is more common in developing countries like Nigeria, where women usually present late with complications of hypertensive disorders while pregnant. While hypertensive disorders in pregnancy are not curable, their progression and complications are largely preventable; hence, it is important to identify at-risk women and institute appropriate measures. Objectives: To determine the incidence of maternal and perinatal morbidity and mortality, and to highlight associated significant risk factors and determine the various outcomes that are influenced by the socio-demographic and clinical characteristics of the women. Method: An eight-year retrospective epidemiological observational study of all women with eclampsia between 1st of January, 2017, to 31st of December 2024 was undertaken in the department of Obstetrics and Gynaecology of Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria. All the types of eclampsia (Antepartum, Intrapartum and Postpartum) were considered, and data analysis included both maternal and fetal parameters with the aid of IBM SPSS Statistics version 29.  Result: This study captured a total of 9,405 deliveries at the Ekiti State University Teaching Hospital over an 8-year period. The total number of eclamptic cases seen within this period was 163, with a prevalence of 17 in 1000 deliveries. The majority of the eclamptic patients (88.3%) were unbooked, while 11.7% were booked. Maternal complications identified included pulmonary oedema (3.7%), acute kidney injury (4.3%), primary postpartum haemorrhage (9.2%) and wound infection (7.4%) amongst others. The mean APGAR scores were 4.6 and 6.2 at the first and fifth minutes, respectively, with a mean birth weight of 2.30±0.72kg. The majority of the patients (86.5%) had a good recovery and were discharged home. The overall maternal mortality was 4.9%, with intrauterine death of 15.3%. Conclusion: The prevalence of eclampsia was 17 in 1000 deliveries. Eclampsia remains a major cause of maternal and perinatal morbidity and mortality in our centre. The major factors responsible for adverse outcomes were unsupervised pregnancies and deliveries. It is important to educate the general public as early booking, adequate antenatal care, and early initiation of treatment can reduce the adverse outcome in patients with eclampsia.