Association of Glasgow Coma Scale with Severe Maternal Morbidity and Mortality in Eclampsia Patient-One Year Audit of Tertiary Care Hospital

Abstract

Objective:  To determine an association between Glasgow coma score and maternal morbidity and mortality in patients presenting with eclampsia in high dependency unit of Maternal and child health centre PIMS.

Design:  Cross-sectional analysis of prospected collected data of one year period.

Setting:  Maternal and child health centre unit II, PIMS hospital Islamabad.

Material and Method:  Records of admitted patients with eclampsia at high dependency unit of   maternal and child health centre PIMS from 1-1-2016 to 31-12-2016 were prospectively maintained and entered in pre-designed study Performa. The GCS was recorded at the time of admission and after treatment. The data was analyzed with respect to association of GCS with maternal mortality and morbidity in terms of ventilatory support, complications, transfer to surgical/medical ICU, surgical intervention. Chi-square test was used for categorical data, t-test for numerical data.

Results:  During the study  period 37 patient  presented with eclampsia .Overall  mortality  was 6(16.22%).The mortality  was  significantly  higher  in GCS Ë‚  9(p-0.047).Similarly significant higher  no  of  patient with GCS Ë‚ 9  required ventilator support (p-0.000). Regarding morbidity  higher incidence of complication was found  in terms of  renal failure, respiratory failure ,neurological failure  and multi organ  failure was  found in GCS Ë‚ 9 .However  the  difference  was not  statistically  significant(p-0.478).

Conclusion: Significant association between GCS and outcome of eclampsia reflects the importance of the scale in eclamptic patient. The tool can be utilized for assessing the need for ventilator support and other interventions besides having high prognostic value in terms of survivors versus non survivors.

Keywords:  Eclampsia, Glasgow Coma Scale, CS, Maternal mortality, Maternal morbidity