A study of maternal deaths from preeclampsia and eclampsia in a tertiary care centre

Background: Hypertensive disorders of pregnancy (HDPs) affect about 10% of all pregnant women around the world and are an important cause of maternal and perinatal mortality and morbidity. In Asia and Africa, nearly one tenth of all maternal deaths are associated with hypertensive disorders of pregnancy. Predicting the onset of these complications could aid in timely interventions such as increased surveillance, treatment of symptoms, transfer to higher care facility and delivery when necessary, which could reduce morbidity and mortality from the HDPs. Aim: It was to calculate the total number of women admitted with hypertensive disorders and eclampsia in the labor room and their case fatality rate, to calculate the number of mothers died from preeclampsia and eclampsia, to critically analyze all the mothers who died from preeclampsia in order to identify the root causes of substandard care leading to maternal deaths. Materials and methods: This prospective study was carried out in the labor room, Department of Obstetrics and Gynecology, King George Hospital, Andhra Medical College for a period of twelve months from November 2016 to October 2017. All the mothers who died from severe preeclampsia and eclampsia were included in the study and they were all analyzed modeled on the United Kingdom Confidential Enquiries into maternal deaths. Results: In one year there were 530 women admitted with hypertensive disorders and 144 with eclampsia giving a prevalence of 9.04% and 2.45% respectively. Case fatality rate of preeclampsia was 2.26% and eclampsia was 4.1%. During the study period there were 44 total maternal deaths. Out of 44 maternal deaths, 12 were from severe preeclampsia and eclampsia making it the second leading cause of maternal mortality in our institute. Conclusion: The majority of deaths related to hypertensive disorders can be avoided by providing timely and effective care to women presenting with complications. Thus, optimization of health care for women during pregnancy to prevent and treat hypertensive disorders of pregnancy is a necessary step towards achievement of the Millennium Development Goals.