University of Khartoum

Treatment of Eclampsia in Khartoum main Hospitals

Treatment of Eclampsia in Khartoum main Hospitals

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Title: Treatment of Eclampsia in Khartoum main Hospitals
Author: Hamid, Amira
Abstract: Background : Eclamptic convulsion is a live threatening condition associated with high maternal and perinatal mortality. It remains a major cause of maternal morbidity and mortality worldwide. Methods: This is a prospective, descriptive, cross-sectional hospital based study, concerned with the management of eclampsia in Khartoum teaching hospital, Khartoum north teaching hospital and Omdurman maternity hospital during the period from November 2002 to March 2003. The study was carried out to analyze the protocol for management of eclampsia in these hospitals. It includes fifty cases who presented with eclampsia, details of management were studied using questionnaire. Results: The incidence of eclampsia was 8.8/1000 total births, and the maternal mortality was 18%. The cause was cerebral heamorrhage in 10% of cases. General life saving measures (O2 therapy, airway, oral suction and input output chart) were taken by some but not all doctors. The anticonvulsant drug used was diazepam in (72%), Mgso4 in (14%) of cases. The doses were not standardized. The frequency of recurrence of convulsions was 84% and the mean time taken for control of convulsions was 18 hrs. The anti-hypertensive drug used was nifedipine in (42%) and dihydralazine in (20%) of cases. The doses were also different from patient to patient and the control of blood pressure was poor (40% at 2 hrs – 54% at 6 hrs – 76% at 24 hrs of delivery). Rate of caesarean section was 72% and mean time interval for delivery was 3.5 hrs. General anesthesia was used in (81%) of cases of abdominal delivery. It was given in all cases by medical assistant. Prolonged impairment of consciousness was noted. Glasgow coma < 8 was noticed in 74% of cases at 24 hours - and in 48% of case at 48 hours after delivery. It was significantly related to the use of diazepam. Conclusion: It is shown from the study that a definite protocol is lacking in these hospitals. The study recommended that a strict protocol for management of eclampsia to be established and the drugs and equipments needed to be made available, with continuous revision of the protocol and its out come.
URI: http://hdl.handle.net/123456789/7486
Date: 2015-03-25


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