Prevalence of Eclampsia and Outcomes Among Women Delivering in Kiryandogo Hospital

Overview
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Table of Contents

DECLARATION .....................................................................................................................................i

APPROVAL ...........................................................................................................................................ii

DEDICATION....................................................................................................................................... iii

ACKNOWLEDGEMENT ..................................................................................................................... iv

LIST OF TABLES................................................................................................................................ vii

LIST OF FIGURES .............................................................................................................................. vii

LIST OF ABBREVIATIONS.............................................................................................................. viii

OPERATIONAL DEFINITIONS.......................................................................................................... ix

ABSTRACT............................................................................................................................................ x

CHAPTER ONE.....................................................................................................................................1

INTRODUCTION ..................................................................................................................................1

1.0 Background...................................................................................................................................1

1.1 Problem statement.........................................................................................................................2

1.2 Objectives of the study..................................................................................................................2

1.2.1 General objective .......................................................................................................................2

1.2.2 Specific objective.......................................................................................................................2

1.3 Research questions........................................................................................................................3

1.4 Significance of the study...............................................................................................................3

1.5 Study scope ...................................................................................................................................3

1.5.1 Geographical scope ....................................................................................................................3

1.5.2 Content scope.............................................................................................................................3

1.5.3 Time scope .................................................................................................................................3

1.6 Conceptual framework..................................................................................................................4

CHAPTER TWO ....................................................................................................................................5

LITERATURE REVIEW .......................................................................................................................5

2.1 Burden of eclampsia .....................................................................................................................5

2.2 Clinical presentation .....................................................................................................................5

2.3 Maternal and perinatal outcome....................................................................................................6

CHAPTER THREE ................................................................................................................................9

METHODOLOGY .................................................................................................................................9

3.1 Study design..................................................................................................................................9

3.2 Study area......................................................................................................................................9

3.3 Study population ...........................................................................................................................9

3.3.1 Inclusion criteria ........................................................................................................................9

3.4 Sample size determination ............................................................................................................9

3.5 Sampling technique.....................................................................................................................10

3.6 Data collection methods..............................................................................................................10

3.7 Data Processing and analysis......................................................................................................10

3.8 Quality control ............................................................................................................................10

3.9 Ethical considerations.................................................................................................................10

3.10 Study limitation.........................................................................................................................10

CHAPTER FOUR.................................................................................................................................11

RESULTS .............................................................................................................................................11

4.0 Graphical representation of results .............................................................................................11

4.1 Sociodemographic characteristics of the respondents.................................................................12

4.2 Obstetric characteristics of patients in the study.........................................................................13

4.3 Prevalence of eclampsia..............................................................................................................13

4.4 Distribution of eclampsia according to characteristics of women ..............................................14

4.5 Maternal outcomes among women with eclampsia ....................................................................15

4.6 Neonatal outcomes and complications........................................................................................15

CHAPTER FIVE ..................................................................................................................................17

DISCUSSION.......................................................................................................................................17

5.1 Discussion...................................................................................................................................17

5.1.2 Prevalence of eclampsia...........................................................................................................17

5.1.3 Maternal outcomes...................................................................................................................18

5.1.4 Neonatal outcomes...................................................................................................................19

CHAPTER SIX.....................................................................................................................................20

CONCLUSION AND RECOMMENDATIONS..................................................................................20

6.1 Conclusion ..................................................................................................................................20

6.2 Recommendations.......................................................................................................................20

APPENDICES ......................................................................................................................................25

Appendix i: Data collection tool for prevalence and outcome of eclampsia ....................................25

Appendix ii: Map of Uganda showing Districts of Uganda..............................................................28

Appendix iii: Introduction Letter......................................................................................................29

ABSTRACT Background: Eclampsia is an acute and life-threatening complication of pregnancy characterized by the appearance of tonic-clonic convulsion with or without coma usually in a patient with pre-eclampsia. In developed countries, its incidence is on declining trends but in developing countries, like Uganda, it still remains the significant contributor to maternal morbidity and death. Therefore, the purpose of this study was to identify the prevalence and outcomes of eclampsia among women delivering at Kiryandongo hospital. Methods: A hospital based descriptive cross-sectional study was carried out among 384 women who had delivered at Kiryandongo hospital between January and December 2018. Data was collected using a pretested questionnaire and analyzed using Statistical Package for Social science (SPSS) version 25. Results were then presented in tables and charts. Results: The mean age of participants was 27.4±5.8 SD. Majority of women 375 (97.7%) were married while 373 (97.1%) were from rural setting. It is observed that; almost all women 376 (99.5%) had attended antenatal care with 293 (76.3%) being multiparous women. Only 2 (0.5%) of the women had a positive history of eclampsia. The study revealed that out of 384 women in the study, only 7 were diagnosed with eclampsia representing a prevalence of 1.8%. Findings reveled that of the 7 mothers who were diagnosed with eclampsia, 3 (42.9%) had complications compared to 4 (57.1%) who did not get any complication. Maternal complications included placenta abruptio 2 (28.6%) and HEELP syndrome 1 (14.3%). Analysis revealed that 3 (42.9%) of the neonates from mothers with eclampsia had no complications while rest 4 (57.1%) had some form of complication. Complications included, low birth weight 2 (28.6%), premature 1.5 (21.4%), and birth asphyxia 1.5 (21.4%). Conclusion and recommendations: The proportion of eclampsia cases in Kiryandongo hospital is low and was common among younger women. The rate of maternal complications xi among mothers with eclampsia is lower than reported in literature. However, neonatal complications rate is higher than most studies. Focus on raising awareness at community level is needed and strengthening of health facilities for early detection, prevention and management of preeclampsia by equipping health facilities to manage the complication related to the complication of mothers and children.

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Prevalence of Eclampsia and Outcomes Among Women Delivering in Kiryandogo Hospital

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