Comparison of Feto-Maternal Outcomes after Caesarean Section and Vaginal Delivery in Eclamptic Patients

Abstract

Introduction: Eclampsia has a high prevalence in our country with a high mortality rate. It is recognized that termination of pregnancy is the only definitive cure ofthe pathophysiological events in eclampsia. A rational therapy for general management, management of hypertension and convulsion has beenestablished in Bangladesh by the Eclampsia Working Group. Methodology: This study was carried out in the Eclampsia Ward, Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, and included 100 consecutively selected patients. In this study, the 50 patients of vaginal delivery group and the 50 patients of caesarean section group were comparable regarding baseline parameters like age, gravidity, socioeconomic status, gestational age, antenatal care and type of eclampsia. Result: Maternal morbidity was significantly high (P<0.01) among women of vaginal delivery group (54%) compared to caesarean section group (16%). Maternal mortality was 4 percent in the vaginal delivery group and none in the caesarean section group. Conclusion: Overall fetal outcome was better among the caesarean section group of patients. Fourteen percent of babies were stillborn in the vaginal delivery group compared to four percent in the caesarean section group. Therefore, early caesarean section may significantly improve thefeto-maternal outcome in eclamptic patients.