ECLAMPSIA AND ITS ASSOCIATION WITH EXTERNAL FACTORS
AbstractBackground: 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
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
Kirsten Duckitt. Risk factors for pre-eclampsia at antenatal
booking: systematic review of controlled studies BMJ
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)
O’ Brien MD, Gilmour-White S, Epilepsy & Pregnancy. BMJ
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
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