ECLAMPSIA AND ITS ASSOCIATION WITH EXTERNAL FACTORS

Authors

  • Surraya Halimi
  • Syed Muhammad Ashhad Halimi

Abstract

Background: Eclampsia remains a leading cause of maternal and perinatal mortality and morbidity.Primigravida are at higher risk of convulsions and antepartum convulsions are more dangerous thanthose beginning after delivery. This study was carried out to evaluate the epidemiological aspects ofpatients presenting with eclampsia in the catchment area of Saidu Teaching Hospital Swat. Methods:This descriptive non-interventional study was carried out in the Department of Obstetrics andGynaecology, Saidu Teaching Hospital Swat from 1st January 2007 to 31st December 2009. Nonprobability consecutive sampling method was used. All patients of eclampsia were included in thestudy. The diagnosis was based on history and confirmed on clinical findings. Inclusion criteria werepatients with hypertension, proteinuria and history of fits during pregnancy; labour and peurperiumwithin 7 days of delivery. Exclusion criteria were history of fits other than eclampsia. Results: A totalof 23,000 admissions were made in the labour ward during the study period. Out of them 108 cases(0.46%) were of eclampsia, 85 were primigravidae with no previous history of hypertension and 23were multigravidae with previous history of hypertension. The seasonal frequency of cases was 34.25%in winters, 17.59% in autumn, 21.29% in summers and 26.85% in spring. The incidence of eclampsiawas 79.62% in primigravida, and 75% in the age group 14–19 years. The prevalence was high(82.40%) in poor socioeconomic class patients. Conclusion: Eclampsia is a common pregnancyassociated disorder in this part of the country especially in primigravida and teenagers. The disorder iscommon in low socioeconomic class. The most important aspect of its management is prevention byproper antenatal check-up, availability of health facilities and prompt referral to tertiary care hospital.Keywords: Eclampsia, Pregnancy, primigravida, seasonal variation

References

Duley L. Maternal mortality associated with hypertensive

disorders of pregnancy in Africa, Asia, Latin America and the

Caribbean. Br J Obstet Gynaecol 1992;99:547‒53.

Piercy CN. In: Handbook of Obstetric medicine. Isis Medical

Media, Oxford, 1997.

Chelsey LC. A short history of eclampsia. Obstet Gynecol

;43:599–602.

Kirsten Duckitt. Risk factors for pre-eclampsia at antenatal

booking: systematic review of controlled studies BMJ

;330:565.

Mosammat Rashida Begum, Anowara Begum, Ehsan Quadir,

Sayeba Akhter, Latifa Shamsuddin. Eclampsia, Still a Problem in

Bangladesh. Med Gen Med 2004;6(4):52.

Begum MR, Begum A, Sultana N, Seasonal Incidence of

eclampsia and its relationship to meteorological data in Dhaka

City. Bangladesh J Obstet Gynaecol 1999;14:6–8.

J Ayub Med Coll Abbottabad 2010;22(3)

http://www.ayubmed.edu.pk/JAMC/PAST/22-3/Halimi.pdf

O’ Brien MD, Gilmour-White S, Epilepsy & Pregnancy. BMJ

;307:492–5.

Douglous KA, Redman CWG. Eclampsia in the United

Kingdom. BMJ 1994:309:1395–400.

Campbell DM, Mac Gallivray I. Pre-eclampsia in second

pregnancy. Br J Obstet Gynaecol 1985;92:131–40.

Okafar UV, Efetie ER, Ekkumankama O. Eclampsia and

seasonal variation in the tropics. Pan African Medical J 2009;2:7.

Neela J, Raman L. Saesonal trends in the occurrence of

eclampsia. Nat Med J India 1993;6(1):17–8.

Magnus P, Eskild A. Seasonal variation in occurrence of

preeclampsia. Br J Obstet Gynaecol 2001;108:1116–9.

Zhang J, Zeisler J, Hatch MC, Berkowitz G. Epidemiology of

pregnancy-induced hypertension. Epidemiol Rev 1997;19:218–32.

Dekker GA, Sibai BM. Etiology and pathogenesis of

preeclampsia: current concepts. Am J Obstet Gynecol

;179:1359–75.

Obed SA, Wilson JB, Elkins TE. Eclampsia: 134 consecutive

cases. Int J Gynecol Obstet 1994;45:97–103.

Tan GWT, Salmon YM. Meteorological factors and preeclampsia. Sing Med J 1988;29:133–7.

Wacker J, Schulz M, Fruhauf J, Chiwora FM, Solomayer E,

Bastert G. Seasonal change in the incidence of preeclampsia in

Zimbabwe. Acta Obstet Gynecol Scand 1998;77:712–6.

Makhseed M, Musini VM, Ahmed MA, Monem RA. Influence

of seasonal variation on pregnancy-induced hypertension and/or

preeclampsia. Aust NZ J Obstet Gynecol 1999;39:196–9.

Ros HS, Cnattingius S, Lipworth L. Comparison of risk factors

for preeclampsia and gestational hypertension in a populationbased cohort study. Am J Epidemiol 1998;147:1062–70.

Rose G. Cold weather and ischemic heart disease. Br J Prev Soc

Med 1966;20:97–100.

Published

2010-09-01