Eclampsia: Feto-Maternal Outcomes in A Tertiary Care Centre in Eastern Nepal

  • Sita Ghimire Department of Obstetrics and Gynaecology. Nobel Medical College, Biratnagar, Nepal.
Keywords: eclampsia; fetomaternal outcomes; retrospective analysis.


Introduction: 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.
Methods: 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.
Results: 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.
Conclusions: 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. 
Keywords: eclampsia; fetomaternal outcomes; retrospective analysis. | PubMed


Pradhan A, Subedi BK, Barnett S, et al. Nepal Maternal
Mortality and Morbidity study 2008/2009.Ramsah path
Kathmandu Nepal: Family Health Divison,Department
of Health Services, Ministry of Health and
Population,Government of Nepal, 2010 (www.nepal usaid.
planning.html) accessed Feb 5 2016
2. Chien PF, Khan KS, Arnott N, et al. Magnesium sulphate
in the treatment of the eclampsia and preeclampsia: an
overview of the evidence from randomized controlled trials.
Br J Obstet Gynecol. 1996;103:1085-91.
3. Chaudhary P. Eclampsia: a hospital based retrospective
study. Kath Univ Med J. 2002;1(4):237-41.

Acharya G, Schultz S: Eclampsia in Patan hospital: A two
year retrospective study. JNMA. 1991;29:254-8.
5. Shakya B, Vaidya A. Overview of eclampsia at a tertiary care
hospital. NJOG. 2013;8(2):46-9.
6. Gautam (Bhattarai) SK, Paudel K, Silwal K. Management
and Outcome of Pre eclampsia/Eclampsia among patient
admitted in maternity ward in tertiary hospital. J Inst Med.
7. Dhakal G, Subedi M, Paudel K. Magnesium Sulphate in
Management of Severe Pre-eclampsia and Eclampsia. J
Nepal Health Res Counc. 2012;10(21):113-7.
8. Rayamajhi AK, Uprety D, Agrawal A, Pokhrel H.
Fetomaternal outcomes in eclampsia. JNMA. 2003;42:341-5.
9. Sunita TH, Rathnamala MD. Eclampsia in a teaching
hospital:incidence,clinical profile and response to
magnesium sulfate by Zuspan regimen. J Dental Med Sci.
10. Singh S, Bahera AK. Eclampsia in Eastern India: Incidence,
demographic profile and response to three different
anticonvulsant regimen of magnesium sulfate. The Int J
Gynecol Obstet. 2011;15:1-7.
11. Douglas KA, Redman CW. Eclampsia in United Kingdom.
Brit Med J. 1994;309(6966):1395-400.
12. Kaur P. A clinical study on eclampsia in a referral hospital. J
South Asian Feder Obst Gynae. 2012;4(2):113-5.
13. Manandhar BL, Chongstuvivatwong V, Greater A. Antenatal
care and severe eclampsia and preeclampsia in Kathmandu
valley. J Chitwan Med Col. 2013;3(6):43-7.
14. Jha R, Verma S, Jha SK. Eclampsia in Janakpur Zonal hospital
,Nepal:Favourable outcome with Magnesium Sulphate. N J
Obstet Gynecol. 2007;2:16-9.
15. Khanum M, Asraf F, Sahrin H. A clinical study of 100 cases
of eclampsia in rajsahi medical college and hospital. TAJ.
How to Cite
Ghimire, S. (2016). Eclampsia: Feto-Maternal Outcomes in A Tertiary Care Centre in Eastern Nepal. Journal of Nepal Medical Association, 54(201), 24-28.
Original Article