Management of eclampsia at Assiut University Hospital, Egypt

Abstract

Objective: To evaluate the protocol used for management of eclampsia at Assiut University Hospital, Assiut, Egypt.

Methods: In a prospective cross-sectional study, data were collected from 1998 women treated for eclampsia at Assiut University Hospital between January 1990 and January 2010, including 1594 cases of prepartum eclampsia, 75 of intrapartum eclampsia, 16 of intercurrent eclampsia, and 313 of postpartum eclampsia. The treatment regimen included use of nifedipine as an antihypertensive, magnesium sulfate as an anticonvulsant, rapid interruption of pregnancy, and admission to the ICU. Data were evaluated for control of blood pressure, prevention and control of convulsions, and maternal and perinatal outcomes.

Results: Magnesium sulfate was effective in controlling convulsions in 98.1% of women. Nifedipine initiated a smooth decline in blood pressure (P>0.0001). There were 79 maternal deaths (3.95%). Maternal morbidity occurred in 439 (22%) women. Twenty-seven percent of women delivered vaginally (most of these women were admitted postpartum). Perinatal mortality occurred in 7.9% of cases.

Conclusion: A combination of nifedipine as an antihypertensive drug, magnesium sulfate as an anticonvulsant, rapid interruption of pregnancy, and managing the patients in the ICU resulted in a marked improvement in the outcome for both mother and fetus at Assiut University Hospital.