Ghimire S
Department of Obstetrics and Gynaecology, Nobel Medical College, Biratnagar, Nepal.
JNMA J Nepal Med Assoc. 2016 Jan-Mar;54(201):24-28.
Eclampsia is a preventable and treatable cause of maternal morbidity and mortality with poor feto-maternal outcome in developing countries. Despite development in the level of health education expertise in human resources and institutional obstetric care in our country, the delay in early recognition of the problem, transportation to proper health facility and getting proper expert care are major hurdles to reduce complications. Therefore, we decided to study feto-maternal outcomes in our setting.
A retrospective cross-sectional hospital based study carried out in Nobel Medical College,Biratnagar, from 17th June 2014 to 16th June 2015. Details and data obtained from Medical Record Section were analysed. All patients with eclampsia were included and fetomaternal outcomes measured in terms of complications. Simple descriptive statistical method was applied for analysis.
Among 8,066 deliveries, 112 had eclampsia with incidence of 13.8/1000 deliveries. Majority (41%) were of <19 years of age. Above 90% were unbooked. Aoubt 63.4% were primiparas and 83% had antepartum eclampsia. Eclamptic fits were more common (41.6%) in 37-40 weeks period of gestation. Fits to delivery interval was more than six hours in 89.1% women and 69.3% women underwent caesarean delivery. About 18.9% women developed eclampsia related complications.Common causes of maternal deaths (5.36%) were pulmonary edema, aspiration pneumonia,cerebrovascular accidents and HELLP syndrome. Perinatal death was nine percent.
Although the obstetric care facilities are improving with time, the feto-maternal outcomes are still poor in our country. Therefore early recognition and proper management are vital to tackle this challenge.
子痫是孕产妇发病和死亡的一个可预防和可治疗的原因，在发展中国家母婴结局较差。尽管我国在健康教育水平、人力资源专业知识以及机构产科护理方面有所发展，但早期识别问题的延迟、前往合适医疗机构的交通问题以及获得适当专家护理仍是降低并发症的主要障碍。因此，我们决定在我们的环境中研究母婴结局。
2014年6月17日至2015年6月16日在比拉特纳格尔诺贝尔医学院进行了一项基于医院的回顾性横断面研究。分析了从病历科获得的详细信息和数据。纳入所有子痫患者，并根据并发症衡量母婴结局。采用简单描述性统计方法进行分析。
在8066例分娩中，112例患有子痫，发病率为13.8/1000例分娩。大多数（41%）年龄小于19岁。超过90%未登记。约63.4%为初产妇，83%患有产前子痫。子痫发作在妊娠37 - 40周期间更为常见（41.6%）。89.1%的妇女抽搐至分娩间隔超过6小时，69.3%的妇女接受了剖宫产。约18.9%的妇女出现子痫相关并发症。孕产妇死亡的常见原因（5.36%）是肺水肿、吸入性肺炎、脑血管意外和HELLP综合征。围产期死亡率为9%。
尽管产科护理设施随着时间的推移在改善，但我国的母婴结局仍然很差。因此，早期识别和适当管理对于应对这一挑战至关重要。
