[Therapeutics indications and prognosis of eclampsia at Dakar University Teaching Hospital].
OBJECTIVE
To study the factors of risk of complications and evaluate the quality of medical and obstetrical management of eclampsia.


METHODS
We performed a retrospective analysis of all cases of eclampsia recorded during the ante- or per partum period from January 1, 2000 to December 31, 2001 at the gynecological and obstetrical clinic at Dakar University Teaching Hospital.


RESULTS
Eclampsia had concerned 78 patients, with an incidence of 8 per 1000 childbirth. The epidemiological profile was primipara (68%), young (average age: 20 years), 36 weeks pregnancy or more (60,3%), evacuation in a state of post critical coma (74.3%), on average after 2 seizures, without medical assistance (64%) with an average diastolic blood pressure of 100 mm Hg. Examinations with strong prognosis value like blood count, creatininemia, coagulation, hepatic transaminases and uricemia were not available in emergency (only 24% of all cases). Medicines prescribed included, nicardipine (63%) and magnesia sulfate (53%); this medical treatment was satisfactory in 34.6% of the cases. Cesarean section was performed in 50%. The prognosis was marked by 17.9% maternal mortality and a perinatal mortality of 359 per 1000 births. The principal risk factors of maternal and perinatal complications were early-onset eclampsia, large number of seizures and late obstetrical treatment.


CONCLUSIONS
Prehospital treatment and availability of early cesarean section must be better organized to improve the prognosis of eclampsia.
Cissé
C-T
CT
Clinique Gynécologique et Obstétricale, CHU de Dakar, BP 15745, Dakar-Fann, Sénégal.
Faye Dieme
M-E
ME
Ngabo
D
D
Mbaye
M
M
Diagne
P-M
PM
Moreau
J-C
JC
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D004461:Eclampsia / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D015600:Glasgow Coma Scale; D006784:Hospitals, Teaching; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D015994:Incidence; D008278:Magnesium Sulfate / Q000627:therapeutic use; D009529:Nicardipine / Q000627:therapeutic use; D010298:Parity; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D012675:Senegal / Q000453:epidemiology
D000927:Anticonvulsants; D000959:Antihypertensive Agents; D008278:Magnesium Sulfate; D009529:Nicardipine