Frequency and fetomaternal outcome of eclampsia in primigravida: an experience at a tertiary care hospital
1Dr Hemasa Gul, 2Shazia Tabassum, 3Nasreen Kishwar
Submission: 15 January 2026 | Acceptance: 26 January 2026 | Publication: 01 March 2026
1Asisstant professor, Department of gynae and obs. Bacha khan medical college Mardan
2Assistant Professor, Department of Obstetrics and Gynaecology, Hayatabad Medical Complex
3Assistant Professor Department of Obstetrics and Gynaecology
Corresponding author:
Nasreen Kishwar
Assistant Professor Department of Obstetrics and Gynaecology
ABSTRACT:
Background: Eclampsia, characterized by seizures in the context of preeclampsia, is a significant contributor to maternal and perinatal morbidity and mortality worldwide. Its occurrence in primigravida poses unique challenges due to their first exposure to pregnancy-related physiological changes. Understanding the frequency and fetomaternal outcomes of eclampsia in this demographic is critical for improving clinical management and outcomes, particularly in resource-limited settings.
Aim: The study aimed to determine the frequency of eclampsia in primigravida and evaluate the associated fetomaternal outcomes at a tertiary care hospital in Peshawar, Pakistan.
Methods: This retrospective observational study was conducted at Hayatabad Medical Complex, Peshawar over a period of 12 months, from October 2023 to September 2024. Data were collected from 50 primigravida patients diagnosed with eclampsia, identified through hospital records. The inclusion criteria were primigravida patients with clinical and diagnostic evidence of eclampsia. Exclusion criteria included patients with pre-existing neurological disorders or other comorbidities influencing the outcome. Key variables assessed included maternal age, gestational age at presentation, mode of delivery, maternal complications (e.g., postpartum hemorrhage, renal failure, and HELLP syndrome), and neonatal outcomes (e.g., birth weight, Apgar score, and perinatal mortality). Descriptive statistics were used to summarize the data, while chi-square and t-tests were employed to identify significant associations between variables.
Results: The frequency of eclampsia among primigravida admitted to the hospital during the study period was 4.3%. The majority of patients (68%) were aged between 18 and 25 years, with the mean gestational age at presentation being 34.5 weeks. Cesarean delivery was performed in 70% of cases due to maternal or fetal indications. Maternal complications included postpartum hemorrhage (28%), acute renal failure (14%), and HELLP syndrome (12%). Maternal mortality was observed in 8% of cases.
Neonatal outcomes revealed that 60% of neonates had a birth weight below 2.5 kg. Low Apgar scores at 5 minutes (<7) were recorded in 46% of neonates, while perinatal mortality was observed in 22%. The presence of severe maternal complications significantly correlated with poor neonatal outcomes (p < 0.05).
Conclusion: Eclampsia in primigravida remains a critical obstetric emergency with significant fetomaternal implications. The findings underscore the need for early identification and timely management of preeclampsia to prevent progression to eclampsia. Strengthening antenatal care services, particularly in resource-constrained settings, is imperative for reducing the burden of this condition and improving outcomes for both mothers and their neonates.
Keywords: Eclampsia, Primigravida, Fetomaternal outcomes, Pre-eclampsia, Tertiary care, Neonatal mortality, Maternal morbidity