[Eclampsia at a teaching hospital in Ivory Coast: management, outcome and prognostic factors].

OBJECTIVE

To analyze the management and evolution of eclampsia in the intensive care units of Côte d'Ivoire.

METHODOLOGY: Retrospective study undertaken in the intensive care units in the University Teaching Hospitals of Cocody and Yopougon from 2001 to 2006. Patients admitted to the intensive care unit for eclampsia were included in this study. The management and evolution (clinical condition at admission, medications used, type of delivery, type of anesthesia, mortality, sequellae, clinical evolution) were studied. Factors predicting mortality were identified with the calculation of odds ratio and confidence interval. The Chi-square of Mantel Haenszel was used with an alpha error = 5%.

RESULTS

The study involved 313 patients with a mean age of 22.7 +/- 6.1 yr. Diazepam was the most frequently used anticonvulsant (50.5% of cases), and dihydralazine was the preferred anti-hypertensive agent (50.2%). Cesarean delivery occurred in 58.5% of cases and vaginal delivery in 41.5%. General anesthesia with intubation was used in 79% of Cesarean deliveries and spinal anaesthesia with bupivacaine 0.5% (dose: 10 in 12.5 mg) in 21%. Treatment was not followed regularly in 31.3% of cases. Maternal and perinatal mortality was 16% and 16.1%, respectively. Risk factors for mortality were: admission from outside of a university hospital, admission delay >12 hr, Glasgow score <or= 8 on admission, status eclampticus and poor compliance to therapy.

CONCLUSION

Maternal mortality is still high in our setting. Vigorous action on the factors associated with bad prognosis should yield a reduction in mortality rate.