Prognosis and impact of Eclampsia in Mauritanie : Study of 83 Cases.

Abstract

Objectives of the study: The objective of this work was to study the incidence and the morbidity and mortality factors of the eclampsia at the Nouakchott National hospital center. Materials and methods : This is a prospective, analytical study of 83 cases (July 1st 2013 and June30th 2014) of eclampsia admitted to the obstetric gynecology department of the CHN. Results: Out of a total of 3 789 deliveries, 83 cases of eclampsia were recorded with an incidence of 2.18 %. The profile found was that of a young woman (average age of 21 years), black in 85.5 %, low socioeconomic level in 76 %, primipare (69.9 %), received in a postcritical coma state %) (On average after 2 seizures), with a term pregnancy (73.02 %), poorly followed (40 %) and referred by a health center or a surrounding regional hospital (69.87 %). The crisis occurred in antepartum and postpartum, respectively, in 67.5 % and 32.5 % of cases. All patients were hypertensive. Lower limb edema and proteinuria were found in 50.61 % and 71 % of patients, respectively. From a therapeutic standpoint, nicardipine was the main antihypertensive agent used (73.49 %) and magnesia sulphate was the most widely administered anticonvulsant (92.77 %). Caesarean section was the most common mode of delivery (87.5 %) for patients receiving antepartum. The prognosis was marked by maternal lethality of 7.22 %. With 6 of the 14 deaths recorded (42.85 %), it is the leading cause of maternal mortality at CHN. Perinatal mortality was 8.42 %. The main risk factors for the occurrence of maternal complications were: young age (≤25 years), primiparity, abnormal osteotendinous reflexes (ROT) and evacuation. The main risk factors for maternal mortality were the absence of perinatal consultation and a Glasgow score ≤9.