An analysis was made of 94 maternal deaths following eclampsia, occurring over a 16-year period. Maternal deaths were high in the very young, primigravida and in elderly women of higher parity. The overall maternal mortality over the years appears the same; while mortality associated with eclampsia seems dependent on time. Factors attributed to high maternal death rate from eclampsia are examined and recommendations made as to their prevention.
PIP: Determinants aside from prenatal care that are responsible for maternal death from eclampsia are analyzed in this study. During the 16-year study period (January, 1972 to December, 1987), there were 169,200 deliveries at the University of Ilorin Teaching Hospital in Nigeria. Of these, there were 651 cases of eclampsia with 94 (14.4%) maternal deaths. Total maternal deaths were 748 during the 16-year study period. 12.6% of these resulted from eclampsia. The maternal mortality rate (MMR) due to eclampsia was 0.6/1000 deliveries. Maternal deaths were high in very young primigravida and elderly women of higher parity. The overall MMR ranged between 2.4 and 7.4/1000 and the rates appear the same over the years. The MMR due to eclampsia was between 0.3 and 1.6/1000 deliveries. The rates differ from year to year. 74% were emergencies; postpartum eclampsia was recorded in 20 (21.3%) cases. Perinatal mortality was 4 times the overall crude perinatal mortality rate for the hospital. Operative delivery was performed in 35 (37.2%) of the 94 cases. Over the 16-year period, eclampsia-related maternal deaths remained high. The overall incidence of eclampsia is 3.8/1000 deliveries. Recommendations for prevention of maternal death from eclampsia include: 1) encouraging high-risk women to eat a high protein diet with unrestricted sodium intake at the normal recommended daily allowance; 2) an improvement in the knowledge, attitudes, and practices of the community and those who make policy in regards to eclampsia; 3) a national program on family health education; 4) improvement of the socioeconomic status of women; and 5) a change in national education policy in support of literacy.