Eclampsia : Before and after magnesium sulphate

Abstract

This study was done to see the incidence and impact of changes in the intervention strategy for the management
of eclampsia in a maternity hospital on maternal and perinatal outcome.
Analysis of case records of all eclampsia cases over two different study periods designated as study period A
(April, 1994 to Oct, 1996) and study period B (April, 2000 to April, 2001) were done. Total number of eclampsia
cases who received intervention over two different study period (46 in study period A and 47 in study period
B) were comparable despite the difference in the duration of study period. During study period A, diazepam
was used as anticonvulsant, whereas magnesium sulphate was used to control fits during study period B.
Incidence of eclampsia has markedly increased in this hospital (0.12% vs 0.29%). Epidemiology and clinical
profile of eclamptic patients do not show remarkable change. There was no maternal death in study period
B (April, 2000 to April, 2001) whereas there was one maternal death in the study period A (April, 1994 to
October, 1996). Marked improvement was noticed in terms of recurrence of fit (19.13% vs 73.91%) with
change in the intervention strategy. Perinatal deaths were fewer in study period B (20% vs 33%). Overall,
it seems that care of eclamptic patients and use of magnesium sulphate as anticonvulsant has resulted in
positive impact on maternal outcome.
Key Words: Eclampsia, Maternal outcome, Perinatal outcome, Intervention strategy.