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\def\makelabel##1{\upshape ##1}}% } {\end{list}\end{raggedright}} \newenvironment{specHead}[2]% {\vspace{20pt}\hrule\vspace{10pt}% \phantomsection\label{#1}\markright{#2}% \pdfbookmark[2]{#2}{#1}% \hspace{-0.75in}{\bfseries\fontsize{16pt}{18pt}\selectfont#2}% }{} \def\TheFullDate{2016-01-15 (revised: 15 January 2016)} \def\TheID{\makeatother } \def\TheDate{2016-01-15} \title{Maternal and Foetal Outcome in Eclampsia Retrospective Study} \author{}\makeatletter \makeatletter \newcommand*{\cleartoleftpage}{% \clearpage \if@twoside \ifodd\c@page \hbox{}\newpage \if@twocolumn \hbox{}\newpage \fi \fi \fi } \makeatother \makeatletter \thispagestyle{empty} \markright{\@title}\markboth{\@title}{\@author} \renewcommand\small{\@setfontsize\small{9pt}{11pt}\abovedisplayskip 8.5\p@ plus3\p@ minus4\p@ \belowdisplayskip \abovedisplayskip \abovedisplayshortskip \z@ plus2\p@ \belowdisplayshortskip 4\p@ plus2\p@ minus2\p@ \def\@listi{\leftmargin\leftmargini \topsep 2\p@ plus1\p@ minus1\p@ \parsep 2\p@ plus\p@ minus\p@ \itemsep 1pt} } \makeatother \fvset{frame=single,numberblanklines=false,xleftmargin=5mm,xrightmargin=5mm} \fancyhf{} \setlength{\headheight}{14pt} \fancyhead[LE]{\bfseries\leftmark} \fancyhead[RO]{\bfseries\rightmark} \fancyfoot[RO]{} \fancyfoot[CO]{\thepage} \fancyfoot[LO]{\TheID} \fancyfoot[LE]{} \fancyfoot[CE]{\thepage} \fancyfoot[RE]{\TheID} \hypersetup{citebordercolor=0.75 0.75 0.75,linkbordercolor=0.75 0.75 0.75,urlbordercolor=0.75 0.75 0.75,bookmarksnumbered=true} \fancypagestyle{plain}{\fancyhead{}\renewcommand{\headrulewidth}{0pt}} \date{} \usepackage{authblk} \providecommand{\keywords}[1] { \footnotesize \textbf{\textit{Index terms---}} #1 } \usepackage{graphicx,xcolor} \definecolor{GJBlue}{HTML}{273B81} \definecolor{GJLightBlue}{HTML}{0A9DD9} \definecolor{GJMediumGrey}{HTML}{6D6E70} \definecolor{GJLightGrey}{HTML}{929497} \renewenvironment{abstract}{% \setlength{\parindent}{0pt}\raggedright \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt \textcolor{GJBlue}{\large\bfseries\abstractname\space} }{% \vskip8pt \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt } \usepackage[absolute,overlay]{textpos} \makeatother \usepackage{lineno} \linenumbers \begin{document} \author[1]{Dr. M. Bansal} \affil[1]{ GOVT. MEDICAL COLLEGE ASSOCIATED WITH MAHARANI HOSPITAL,} \renewcommand\Authands{ and } \date{\small \em Received: 12 December 2015 Accepted: 2 January 2016 Published: 15 January 2016} \maketitle \begin{abstract} Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia.Pre-eclampsia is a disorder of pregnancy in which there is high blood pressure and either large amounts of protein in the urine or other organ dysfunction, Onset may be before, during, or after delivery.Most often it is during the second half of pregnancy. The seizures are of the tonic-clonic type and typically last about a minute. Following the seizure there is typically either a period of confusion or coma.Pre-eclampsia is estimated to affect about 5% of deliveries while eclampsia affects about 1.4% of deliveries. In the developed world rates are about 1 in 2,000 deliveries due to improved medical care. Hypertensive disorders of pregnancy are one of the most common causes of death in pregnancy. \end{abstract} \keywords{} \begin{textblock*}{18cm}(1cm,1cm) % {block width} (coords) \textcolor{GJBlue}{\LARGE Global Journals \LaTeX\ JournalKaleidoscope\texttrademark} \end{textblock*} \begin{textblock*}{18cm}(1.4cm,1.5cm) % {block width} (coords) \textcolor{GJBlue}{\footnotesize \\ Artificial Intelligence formulated this projection for compatibility purposes from the original article published at Global Journals. However, this technology is currently in beta. \emph{Therefore, kindly ignore odd layouts, missed formulae, text, tables, or figures.}} \end{textblock*} \let\tabcellsep& \section[{I. Introduction}]{I. Introduction}\par hough by the end of 20 th century, eclampsia has become almost unknown to obstetrician in the developed countries. It is still remains an important factor of maternal and perinatal morbidity and mortality in the developing countries like India.\par Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia.\par Pre-eclampsia is a disorder of pregnancy in which there is high blood pressure and either large amounts of protein in the urine or other organ dysfunction, Onset may be before, during, or after delivery.\par Most often it is during the second half of pregnancy. The seizures are of the tonic-clonic type and typically last about a minute. Following the seizure there is typically either a period of confusion or coma.\par Pre-eclampsia is estimated to affect about 5\% of deliveries while eclampsia affects about 1.4\% of deliveries. In the developed world rates are about 1 in 2,000 deliveries due to improved medical care. Hypertensive disorders of pregnancy are one of the most common causes of death in pregnancy.\par They resulted in 29,000 deaths in 2013 -down from 37,000 deaths in 1990. Around one percent of women with eclampsia die.\par The word eclampsia is from the Greek term for lightning. The first known description of the condition was by Hippocrates in the 5th century BCE.\par Typically the pregnant woman develops hypertension and proteinuria before the onset of a convulsion, the hallmark of eclampsia. Other cerebral signs may immediately precede the convulsion, such as nausea, vomiting, headaches, and cortical blindness.\par If the complication of multi-organ failure ensues, signs and symptoms of those failing organs will appear, such as abdominal pain, jaundice, shortness of breath, and diminished urine output.\par The fetus may develop intrauterine growth retardation, and with maternal convulsions, bradycardia, and fetal distress. Placental bleeding, and placental abruption may also occur.\par Sometimes the pregnant woman becomes comatose without preceding convulsions. Upon awakening from the coma, some experience amaurosis fugax: a "dark" and "fleeting" unilateral temporary blindness. \section[{II. Material and Methods}]{II. Material and Methods}\par This study was carried out in the department of Obs and Gyn, GMC Jagdalpur, Chattisgarh. \section[{IV. Discussion}]{IV. Discussion}\par All cases including antenatal and postnatal eclampsia were received standard Pritchard regimen with MgSo4. (loading 4 gm iv followed by 5 gm im on each alternate buttock).\par Induction of labour was done in all antenatal eclampsia irrespective of gestation age.\par Monitoring of labour was carefully done, simultaneously investigation was send and complication of ecalmpsia also noted which leads to maternal morbidity and mortality.\par All patients were derived within 24 hours of induction of labour.\par Normal vaginal delivery occurs in 48(87.27\%) cases and LSCS was performed in 3 (5.45\%) cases in view of foetal distress.\par Out of Total Deliveries, 24 babies was live birth and 27 babies was IUD and perinatal mortality is around 53\%.\par Out of 66 cases of ecalmpsia, 59 patients were discharge after 1 week without any complication, one patient was absconded after two days of delivery and 6 cases had mortality.\par Out of 6 cases 2 patient were expired due to massive PPH, 2 due to ARF, one due to CVA and one due to DIC. \section[{V. Conclusion}]{V. Conclusion}\par In developed countries, incidence of eclampsia is markedly reduced over last 50 years. But in developing countries like ours-incidence is very high ranging from 0.5 to 1.8\%. In remote places, however incidence is > 4\%.\par In our study incidence is 2.31\%. This is mainly due to lack of awareness about disease, women illiteracy, poor transport facilities and delayed referral. Maternal mortality in the present study is 9\%.\par Most of the Indian reports, Maternal mortality is between 8-14\%.\par The three delays framework commonly used to understand contribution to maternal death are ? Phase I delay-Delay in deciding to seek care on part of patient and family. Incidence of eclampsia should be reduced so as to reduce the maternal mortality and improve fetal outcome. Despite the focus on maternal health over last 50 years antenatal care is very low. It is necessary to create awareness among society and to bring quality care in reach of those who need it.\par In 21 st century we really don't want any single mother to die of eclampsia. \section[{Volume XVI Issue III Version I}]{Volume XVI Issue III Version I}\begin{figure}[htbp] \noindent\textbf{} \par \begin{longtable}{P{0.8235679214402619\textwidth}P{0.01530278232405892\textwidth}P{0.011129296235679214\textwidth}} were gravida two and 14 cases were more than three\tabcellsep \tabcellsep \\ gravida.\tabcellsep \tabcellsep \\ 55 (83.33\%) cases of antenatal eclampsia and\tabcellsep \tabcellsep \\ 11(17.66\%) cases of postnatal eclampsia were reported\tabcellsep \tabcellsep \\ to the hospital.\tabcellsep \tabcellsep \\ Out of antenatal ecalmpsia, 34 (61.8\%) cases\tabcellsep \tabcellsep \\ were full term (37 weeks completed) and 21 (38.18\%)\tabcellsep \tabcellsep \\ were preterm.\tabcellsep \tabcellsep \\ T\tabcellsep \tabcellsep \\ \multicolumn{3}{l}{III. Observation}\\ \multicolumn{3}{l}{The patients were analysed with respect to age,}\\ \multicolumn{3}{l}{parity, booked/unbooked status, gestational age, type of}\\ \multicolumn{3}{l}{eclampsia, mode of delivery and outcome of mother}\\ and fetus\tabcellsep \tabcellsep \\ \multicolumn{3}{l}{All patients with eclampsia has received}\\ \multicolumn{3}{l}{standard Pritchard regimen with MgSo4.}\\ \multicolumn{3}{l}{Out of 2856 deliveries in year 2013-14, 66}\\ \multicolumn{3}{l}{patients were admitted with eclampsia, so overall}\\ \multicolumn{2}{l}{incidence of ecalmpsia is 2.31\%.}\tabcellsep \\ \multicolumn{3}{l}{This hospital is located in most remote area of}\\ \multicolumn{3}{l}{chattisgarh and most of the patients are coming from}\\ rural area.\tabcellsep \tabcellsep \\ \multicolumn{3}{l}{Area wise distribution of eclampsia, from rural}\\ \multicolumn{3}{l}{area, 56 cases (84.84\%) and urban area 10 cases}\\ (15.15\%) were recorded.\tabcellsep \tabcellsep \\ \tabcellsep Age\tabcellsep \\ Age of patients\tabcellsep \multicolumn{2}{l}{Number of cases}\\ 18-20 yrs\tabcellsep \tabcellsep 25\\ 20-25 yrs\tabcellsep \tabcellsep 28\\ 25-30 yrs\tabcellsep \tabcellsep 10\\ 30-35 yrs\tabcellsep \tabcellsep 03\\ \multicolumn{3}{l}{Most of the eclampsia patients were reported}\\ \multicolumn{3}{l}{with age between 20-25 yrs and 18-20 yrs i.e. 28, 25}\\ respectively\tabcellsep \tabcellsep \\ \multicolumn{3}{l}{Cases Percentage}\\ Primigravida\tabcellsep 46\tabcellsep 69.7\\ Multigravida\tabcellsep 20\tabcellsep 30.3\\ \multicolumn{3}{l}{46(69.7\%) patients were primigravida and}\\ \multicolumn{3}{l}{20(30.3\%) case were multigravida, including 6 cases}\end{longtable} \par \caption{\label{tab_0}}\end{figure} \begin{figure}[htbp] \noindent\textbf{} \par \begin{longtable}{P{0.2157142857142857\textwidth}P{0.6342857142857142\textwidth}} \tabcellsep Our goal is to reduce the incidence and so the\\ \tabcellsep maternal mortality\\ \tabcellsep But how????\\ \tabcellsep ? Early detection of PIH and continous followup.\\ \tabcellsep ? Creating awareness among family members and\\ \tabcellsep patients for the disease and its deadly outcome.\\ \tabcellsep ? Creating awareness among health personals\\ \tabcellsep including mitanins and dais.(ASHA workers)\\ \tabcellsep ? Access to transport facility\\ \tabcellsep ? Timely referral is very important.\\ \tabcellsep ? Basic t/t at primary level specially at PHC \& CHC\\ Year 2016\tabcellsep level. How to prevent??.?\\ 2\tabcellsep \\ Volume XVI Issue III Version I\tabcellsep \\ D D D D ) E\tabcellsep \\ (\tabcellsep \\ Medical Research\tabcellsep \\ Global Journal of\tabcellsep \\ ? Phase III delay-Delay in receiving adequate care at\tabcellsep \\ the facility.\tabcellsep \end{longtable} \par \caption{\label{tab_1}}\end{figure} \footnote{© 2 016 Global Journals Inc. (US) Maternal and Foetal Outcome in Eclampsia Retrospective Study} \footnote{© 2016 Global Journals Inc. (US) Maternal and Foetal Outcome in Eclampsia Retrospective Study} \backmatter \begin{bibitemlist}{1} \bibitem[Smith et al.]{b5}\label{b5} \textit{}, Jm; Smith , Lowe , J; Rf; Fullerton , S M Currie . \bibitem[Abalos and Cuesta]{b8}\label{b8} \textit{}, E; Abalos , C Cuesta . \bibitem[Mcdonald et al. (2012)]{b7}\label{b7} ‘A systematic review of maternal and infant outcomes following magnesium sulfate for preeclampsia/eclampsia in real-world use’. Mcdonald , O; Sd; Lutsiv , N; Dzaja , L Duley . \textit{Gynaecology and Obstetrics} August 2012. 118 (2) p. . (International journal of gynaecology and obstetrics: the official organ of the International Federation of) \bibitem[Li et al. (2003)]{b18}\label{b18} ‘Adrenomedullin is decreased in preeclampsia because of failed response to epidermal growth factor and impaired syncytialization’. 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