Need for relooking into management of eclampsia

Objective: To explore the incidence, types, profiles, gestation, therapies, maternal-fetoneonatal\udoutcomes with special reference to conservative eclampsia management in preterm cases with\udlive baby. Methods: A critical analysis of eclampsia cases over two decades was performed to\udexplore outcomes with different therapies. Results: Of 64 014 deliveries, 416 cases of eclampsia\udwere managed, giving an incidence of 0.65% of births with decreasing trends (0.79% in Block A\udand 0.56% in Block E). 132 (31.73%) had lytic cocktail, (58.69% in Block A and 2.66% in Block E), 76\ud(18.27%) had magnesium sulphate (MgSO4) and pethidine or diazepam (30.43% in Block A and 5.33%\udin Block E), 208 (50.00%) received MgSO4 and nifedipine (10.86% in Block A and 92.00% in Block\udE). Mean induction delivery interval with lytic cocktail was 23.2 hours (shortest), and MgSO4 with\udsedatives, 48 hours, and MgSO4 with nifedipine, 72 hours (longest). In 33 cases, induction could\udbe postponed if babies were live, preterm and mothers ’ convulsions could be controlled. Lytic\udcocktail perinatal mortality rate (PMR) was 765.15. PMR of MgSO4 with sedatives was 500. PMR\udof MgSO4 with nifedipine was 346. Conclusions: Though some babies died in utero, in carefully\udselected cases with close supervision, pregnancy may be continued with eclampsia to increase\udfetal maturity without risk to mother, in settings where resources are scarce for very very low birth\udweight babies. Conservative management improves perinatal outcome but a careful balance of\udmaternal wellbeing is essential