Comparison of emergency caesarean section to misoprostol induction for the delivery of antepartum eclamptic patients: a pilot study

Abstract

Background: Eclampsia has now emerged as one of the commonest cause of maternal mortality in Nigeria. There is need for research on best modality for delivery of eclamptics.

Methodology: The pilot study was conducted on 50 eclamptic patients at the Federal Medical Centre, Azare. The patients were randomized for delivery either by caesarean section (CS) or induction of labour. The fetomaternal outcome of the two groups was compared.

Results: 25 of the patients had CS and 25 had induction of labour with misoprostol. The mean decision delivery interval was 4.1 hours and 13.08 hours for the CS and misoprostol groups respectively. Misoprostol failure was recorded in 4 (16%) patients and they were subsequently delivered by CS. The duration of admission was longer in the CS group (mean of 10.1 days) compared to the misoprostol group (mean of 6.08 days). There were more maternal complications and admissions of babies into the SCBU in the CS group. Maternal mortality in the two groups was similar (2% each).

Conclusion: Misoprostol is cheap, available and safe for delivery of antepartum eclamptics. In the event of delay at caesarean section for antepartum eclamptics patients, misoprostol induction should be started. A multicenter study is called for.