title: Does route of delivery affect maternal and perinatal outcome in women with eclampsia? A randomized controlled pilot study.
abstract: OBJECTIVE
  The route of delivery in eclampsia is controversial. We hypothesized that adverse maternal and perinatal outcomes may not be improved by early cesarean delivery.
  
  
  METHODS
  This was a randomized controlled exploratory trial carried out in a rural teaching institution. In all, 200 eclampsia cases, carrying ≥34 weeks, were allocated to either cesarean or vaginal delivery. Composite maternal and perinatal event rates (death and severe morbidity) were compared by intention-to-treat principle.
  
  
  RESULTS
  Groups were comparable at baseline with respect to age and key clinical parameters. Maternal event rate was similar: 10.89% in the cesarean arm vs 7.07% for vaginal delivery (relative risk, 1.54; 95% confidence interval, 0.62-3.81). Although the neonatal event rate was less in cesarean delivery-9.90% vs 19.19% (relative risk, 0.52; 95% confidence interval, 0.25-1.05)-the difference was not significant statistically.
  
  
  CONCLUSIONS
  A policy of early cesarean delivery in eclampsia, carrying ≥34 weeks, is not associated with better outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Bankura Sammilani Medical College, Bankura, West Bengal, India. sealsubrata@gmail.com
authors.forename: Subrata Lall
authors.initials: SL
authors.lastname: Seal
authors.forename: Debdutta
authors.initials: D
authors.lastname: Ghosh
authors.forename: Gourisankar
authors.initials: G
authors.lastname: Kamilya
authors.forename: Joydev
authors.initials: J
authors.lastname: Mukherji
authors.forename: Avijit
authors.initials: A
authors.lastname: Hazra
authors.forename: Pratima
authors.initials: P
authors.lastname: Garain
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001034:Apgar Score; D002585:Cesarean Section; D003422:Critical Care / Q000706:statistics & numerical data; D004461:Eclampsia / Q000188:drug therapy / Q000401:mortality; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D057194:Intention to Treat Analysis; D007741:Labetalol / Q000627:therapeutic use; D008278:Magnesium Sulfate / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D054238:Perinatal Mortality; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors
chemical_list: D000927:Anticonvulsants; D000959:Antihypertensive Agents; D008278:Magnesium Sulfate; D007741:Labetalol