ABSTRACT
Objective: to determine demographic factors, maternal and perinatal outcome of eclamptic women in health care facilities across Pakistan participating in WHO Multi country survey.
Design: a cross-sectional study
Setting: this cross-sectional study was conducted in 16 health care facilities across Pakistan in federal capital, provinces Punjab and Sind.
Study Duration: from 1st March to 30th May 2011.
Methodology: hospital records were obtained to collect data of women who delivered in the studied facilities or admitted within 7 days of delivery or abortion and data of women who developed eclampsia was retrieved for this study. Data was entered and analyzed in SPSS using chi-square and logistic regression models. The main outcome measures were demographic factors and maternal and neonatal outcome in women with eclampsia.
Results: overall 13175 women delivered within the period, out of which 56 had eclampsia with an incidence of 4.2 per thousand deliveries. There were 3 maternal deaths, with a case fatality rate of 5.3 %. Eclampsia was commonest in age group of 20 – 40 years (91 %). Primigravidas constituted 58.9 % (33 ) of cases. Illiteracy was found in 55.4 % of cases. Majority of the women were delivered preterm at < 37 weeks of gestation 71.4 %.(40). Ceasarean section (CS) was the most common (66.1 %) mode of delivery and prophylactic antibiotics were used in 82.1 % women. Ante partum and intrapartum eclampsia was more commonly seen (98.2 %) than postpartum eclampsia. Fifty three women (94.6 %) received magnesium sulphate. Among the Neonates there were 73.21% (41) low birth weight (LBW) babies. Perinatal mortalities were 24 % (14) and infants with APGAR  Score < 5 were 28.5%.
Conclusion: eclampsia is one of the major causes of maternal and neonatal morbidity and mortality. Maternal education, awareness and easy access to health care facilities is of utmost importance. Sensitization of antenatal clients about danger signs of pre-eclampsia / eclampsia along with the emergency obstetric care services should be available at all health care facilities especially at grass root levels.
Key Words: Eclampsia, Primigravida, Perinatal mortality, Preterm, Health facilities.

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