Incidence, Risk Factors, and Associated Complications of Eclampsia

obstetric and gyneacology

Objective: The aim of this study was to analyze the incidence, morbidity, and mortality factors associated with eclampsia at the Cheikh Zayed Hospital Centre of Nouakchott (CHCZ). Materials and methods: This is a retrospective, descriptive study of 108 patients hospitalized for eclampsia in the gynecology-obstetrics unit and/ or intensive care of the CHCZ in Nouakchott over a two-year period, from 1 January 2022 to 31 December 2023. Results: Of the 15,540 deliveries during the study period, 108 cases of eclampsia were recorded, representing a frequency of 0.69%. The average age of the patients was 25.14 years, with the majority in the 20-25 age group (32.3%). The average was 2.9, with 60.2% being primiparous. As regards previous history, 18.5% of patients had arterial hypertension. Antenatal follow-up was inadequate in 88% of cases. The mean gestational age at onset of eclampsia was 34 weeks' gestation, with 68.4% of cases occurring before term. Eclampsia occurred gestation antepartum in 64.8% of cases. The main symptom described was headache (75.2%). On admission, 72.9% of patients presented with consciousness disorders, and severe arterial (≥160/110 hypertension mmHg) was noted in 76.8% of cases. Proteinuria was greater than or equal to 3 crosses in 81.6% of cases. Paraclinical findings included anemia in 80.5% of cases, thrombocytopenia in 38% and hyperuricemia in 29.6%. Liver cytolysis was observed in 24% of patients, associated with HELLP syndrome in 13%. The most used antihypertensive treatment was nicardipine (61%). All patients had received magnesium sulphate as an anticonvulsant according to the protocol Zuspan. Pregnancy was terminated by caesarean section in 83.3% of cases. Complications were dominated by renal (31.8%), followed by failure help syndrome (29.5%), coagulation disseminated intravascular 6%) and acute lung oedema (9.1%). Conclusion: The average length of hospitalization was 5 days. Maternal mortality was 0.45‰, with acute renal failure being the leading cause of death (42.9%). Perinatal mortality was 12.9%, most of which occurred in the early neonatal period.

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