Maternal Mortality Associated with Eclampsia and Severe Preeclampsia of Pregnancy

OBJECTIVE: To analyse factors associated with maternal mortality in eclampsia and preeclampsia. METHOD: Retrospective analysis of 69 maternal deaths due to (eclampsia-61; severe preeclampsia-8) was carried out during a period of 17 years (1982-1998). Maternal condition on admission, associated complications and principal cause of death was analysed in each case. RESULTS: Mean time interval between hospitalization and maternal death was 49.56 +/- 62.01 hrs (1-240 hrs). Twenty (28.9%) women died undelivered. Twenty-three (37.7%) women were in grade IV coma and 52.4% of eclampsia patients had recurrent convulsions (> 10) prior to admission. Associated complications in form of hemorrhage, cerebrovascular accidents, acute renal failure, jaundice, aspiration pneumonia and pulmonary oedema were 30.4, 31.8, 34.8, 18.8, 17.8, and 5.8%, respectively. Maternal mortality in eclampsia was significantly low in time period B (4.1%) when magnesium sulphate was used as an anticonvulsant. CONCLUSIONS: Maternal condition on admission and associated complications are the major determinant of maternal outcome. Use of magnesium sulphate is associated with significant reduction of maternal mortality.