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. 2021 Aug;71(4):369-378.
doi: 10.1007/s13224-021-01432-x. Epub 2021 Mar 4.

Comparison of Fetomaternal Outcome Between Planned Vaginal Delivery and Planned Cesarean Section in Women with Eclampsia: Observational Study

Snehamay Chaudhuri  1 , Dipak Kumar Giri  1 , Arpita Mondal  1   2 , Rashmi Rani  1 , Vaitheeswari Janani  1 , Malay Mundle  3
Affiliations

Comparison of Fetomaternal Outcome Between Planned Vaginal Delivery and Planned Cesarean Section in Women with Eclampsia: Observational Study

Snehamay Chaudhuri et al. J Obstet Gynaecol India. 2021 Aug.

Abstract

Objective: The route of termination of pregnancy in eclampsia is not clearly established. This study aims to compare the fetomaternal outcome between planned vaginal delivery and planned cesarean section in women with eclampsia after 34 weeks of gestation.

Methods: This prospective observational study was conducted in the department of Obstetrics and Gynecology, Midnapore Medical College, West Bengal, India. 182 women with eclampsia carrying 34 weeks or more gestation were allocated to either cesarean(CD) or vaginal delivery (VD) group. The primary measure of outcome was severe maternal outcome. Secondary measures of outcome were perinatal mortality and morbidity.

Results: Of the 62 women allocated in vaginal delivery (VD) group, 60 women (32.97%) had vaginal delivery and 122 (67.03%) had undergone cesarean delivery (CD). Severe maternal outcome was more common in VD group in comparison with CD group (72.5% vs 27.5%, P < 0.00001 RR 2.64 OR 6.98). Perinatal outcome in relation to Apgar score at 5 min, still birth was better in CD group than VD group. Perinatal death was higher in VD group when compared with CD group (25.8%; vs. 8.33%; P = 0.002, RR 3.1 OR 3.83).

Conclusion: There is increasing trend of delivering the eclampsia mother at > 34 weeks of gestation by cesarean section instead of inducing labor and delivering vaginally. Cesarean section when chosen as method of delivery does not increase morbidity or mortality.

Keywords: Cesarean delivery; Eclampsia; Maternal morbidity; Maternal near miss and severe maternal outcome maternal mortality; Perinatal mortality and perinatal morbidity.

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Conflict of interest statement

Conflict of interestThere was nothing to disclose regarding financial, personal, political, intellectual or religious interests. There is no conflict of interests.

Figures

Fig. 1
Fig. 1
Flowchart depicting study subject flow. 33 women were excluded as 12 women were received at active labor (OS > /4 cm dilated). 6 had diagnosed IUFD. 4 had h/o previous cesarean section due to eclampsia. 3 had malpresentation, and 2 had twin pregnancy. 4 had intrapartum convulsions, 2 had < 34 weeks gestation
See this image and copyright information in PMC

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