PREVALENCE OF ECLAMPSIA AMONG PREGNANT WOMEN

CHAPTER ONE

1.0 Introduction

Eclampsia is a severe complication of preeclampsia, marked by the onset of seizures in a woman with preeclampsia during pregnancy, labor, or postpartum. It is a significant cause of maternal and perinatal morbidity and mortality, particularly in low-resource settings. Eclampsia contributes to adverse outcomes for both the mother and the child, making it a critical area of study, especially in rural healthcare settings where access to comprehensive maternal care is limited (WHO, 2016).

This study focuses on the prevalence of eclampsia among women of childbearing age attending the Primary Health Care (PHC) center in Gozaki, Kafur Local Government, Katsina State. Given the potential risks associated with eclampsia, identifying the prevalence and causes in this specific population is vital to improving maternal health outcomes. Additionally, the study aims to explore the management and complications of eclampsia, along with educating the community on the importance of maternal health care.

Eclampsia, which is considered a complication of severe preeclampsia, is commonly defined as new onset of grand mal seizure activity and/or unexplained coma during pregnancy or postpartum in a woman with signs or symptoms of preeclampsia.  It typically occurs during or after the 20th week of gestation or in the postpartum period. Nonetheless, eclampsia in the absence of hypertension with proteinuria has been demonstrated to occur in 38% of cases reported in the United Kingdom.  Similarly, hypertension was absent in 16% of cases reviewed in the United States. 

The clinical manifestations of maternal preeclampsia are hypertension and proteinuria with or without coexisting systemic abnormalities involving the kidneys, liver, or blood. There is also a fetal manifestation of preeclampsia involving fetal growth restriction, reduced amniotic fluid, and abnormal fetal oxygenation.  HELLP syndrome is a severe form of preeclampsia and involves hemolytic anemia, elevated liver function tests (LFTs), and low platelet count.

Most cases of eclampsia present in the third trimester of pregnancy, with about 80% of eclamptic seizures occurring intrapartum or within the first 48 hours following delivery. Rare cases have been reported before 20 weeks’ gestation or as late as 23 days’ postpartum. Although there are numerous studies exploring ultrasound and biomarker prediction of patients at risk of pre-eclampsia, other than early detection of preeclampsia, no reliable test or symptom complex predicts the development of eclampsia. In developed countries, many reported cases have been classified as unpreventable (US Gov, 2013).

1.1 Background of the Study

Eclampsia is an advanced form of hypertensive disorders in pregnancy and is often preceded by preeclampsia, characterized by high blood pressure and signs of organ damage, typically after the 20th week of pregnancy. The exact cause of eclampsia remains unclear, but risk factors include chronic hypertension, age, obesity, and lack of antenatal care. The condition is preventable with early detection and proper management, but in regions where healthcare services are limited, it remains a significant cause of maternal death.

In rural areas like Gozaki, many pregnant women may lack access to regular antenatal care, which increases the risk of developing eclampsia. The traditional practices and socio-economic conditions in such areas often exacerbate the problem. Investigating the prevalence of eclampsia and related factors in this context can help identify specific challenges and provide insights into better healthcare strategies for preventing maternal deaths. (Ahmed et al, 2012)

1.2 Problem Statement

Eclampsia continues to be a life-threatening condition for many pregnant women, particularly in developing regions with limited healthcare resources. In Gozaki, Kafur Local Government, the number of maternal deaths associated with eclampsia raises concerns about the effectiveness of prenatal care and maternal health education. Despite global efforts to reduce maternal mortality rates, many pregnant women in this region may still face risks due to inadequate knowledge, poor healthcare infrastructure, and delayed access to medical services.

This study seeks to determine the prevalence of eclampsia among pregnant women attending PHC Gozaki and explore the factors contributing to its occurrence. Identifying these factors is crucial in formulating strategies to reduce the incidence of eclampsia and improve maternal health in the area.

1.3 Objectives of the Study

1. To determine the prevalence of eclampsia among pregnant women attending PHC Gozaki.
2. To identify the major causes of eclampsia among pregnant women in the area.
3. To assess the management strategies employed for patients with eclampsia at the healthcare center.
4. To identify complications associated with eclampsia in the study population.
5. To educate the community on the importance of maternal self-care during pregnancy to reduce the risk of eclampsia.

1.4 Research Questions

1. What is the prevalence of eclampsia among pregnant women attending PHC Gozaki?
2. What are the major causes of eclampsia among pregnant women in the area?
3. How to manage the strategies employed for patients with eclampsia at the healthcare center?
4. What are the complications associated with eclampsia in the study population?
5. What are the ways to educate the community on the importance of maternal self-care during pregnancy to reduce the risk of eclampsia.

1.5 Significance of the Study

The findings from this study will provide vital information on the prevalence and causes of eclampsia in Gozaki, contributing to the body of knowledge on maternal health in rural settings. The study’s outcomes will also offer practical insights into improving the management of eclampsia in primary healthcare centers, which can inform policy-making and healthcare interventions. Additionally, through health education, the study aims to raise awareness among pregnant women and the community on the importance of antenatal care and early detection of eclampsia, potentially reducing maternal and perinatal mortality.

1.6 Scope of the Study

This study will focus on pregnant women of childbearing age attending PHC Gozaki, Kafur Local Government. It will investigate the prevalence of eclampsia, the causes, and complications associated with it, as well as the management strategies employed by healthcare providers. The study will also incorporate community education on maternal health care to foster better health practices among the women in the area.

1.7 Operational Definition of Terms

Eclampsia:

A serious condition that involves the occurrence of seizures in pregnant women with preeclampsia.

Preeclampsia:

A pregnancy complication characterized by high blood pressure and damage to other organ systems, often the liver and kidneys.

Antenatal Care:

Medical care and treatment provided to pregnant women before childbirth to ensure a healthy pregnancy and delivery.

Maternal Mortality:

The death of a woman during pregnancy, childbirth, or within the postpartum period, usually due to complications from pregnancy or childbirth.

Hypertensive Disorders of Pregnancy:

A group of conditions in pregnancy that include gestational hypertension, preeclampsia, and eclampsia, characterized by high blood pressure.