Research to Estimate Ten-year Contribution of Eclampsia to Maternal Mortality at a Tertiary Level Health Facility, Makurdi, Benue State, North-Central Nigeria

Abstract

Background: Eclampsia is responsible for over 50,000 maternal deaths with incidence of 1 death in about 100 - 1500 deliveries in developing nations. It is a severe pregnancy complication associated with high maternal and perinatal morbidity and mortality especially in low resource countries. Nigeria accounts for the highest maternal mortality ratio of 512 deaths per 100,000 live deliveries and eclampsia is one of the major contributors to maternal mortality in this country. The Objective: The Objective of this study is to estimate the prevalence, types and causes of maternal mortality due to eclampsia. Materials and Methods: This was a retrospective descriptive study involving 1,523 cases of eclampsia related complications at the Federal Medical Centre (FMC), Makurdi, Benue State, North Central, Nigeria over a 10-year period from January 2011 to December 2020. A pre-designed proforma was used to extract data from the Hospital records which include sociodemographic characteristics of the patients, type of eclampsia, time of presentation to the facility and complications to determine the prevalence, types, and causes of maternal mortality associated with eclampsia.  Data was analyzed using SPSS version 25. Ethical approval was obtained from the Institution Health Research Ethics Committee of FMC, Makurdi. Results: Eclampsia accounted for 46.8% of maternal deaths with a prevalence of 3.5% and with the case-fatality rate of 10% during the study period. The highest prevalence of eclampsia was observed among patients who were in the age group of 15-19 years of age (37.3%). The primigravidae (57.5%) and those with no formal education (76.5%) residing predominantly in rural communities (86.9%) were observed to be worst affected. Furthermore, the majority of patients who died due to eclampsia-related complications were un-booked for antenatal care (94.1%). The occurrence of Eclampsia was more frequent during the antepartum period (71.2%). The leading cause of death in eclampsia cases was pulmonary edema (47.1%). Conclusion: Eclampsia remains a significant cause of maternal morbidity and mortality. Promoting antenatal care and hospital delivery is crucial in reducing the burden of eclampsia.