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Eclampsia as a cause of maternal mortality

OBJECTIVE: to assess the factors associated with maternal mortality resulting from eclampsia. METHODS: a retrospective cohort study reviewing the medical records of deliveries carried out at the Sorocaba Hospital Compound (between January 1995 and December 2005). The variables included were: year of delivery, social and demographic characteristics of mother, personal, family and obstetric history, characteristics of the pregnancy, delivery and puer-perium, the kind care given, the evolution of the case, and the conditions for release from hospital. The statistical analysis involved the use of Fisher 's exact test, the Pearson correlation and Poisson 's multiple regression. RESULTS: 35 973 deliveries were registered, 179 of which involved cases of eclampsia, 52 of them with serious complications, twenty-three resulting in a longer stay in intensive care and eight in death. The incidence of eclampsia decreased over the period (from 0.90% to 0.37%; r= -0.746;p= 0.008), although the proportion of cases with serious complications remained unchanged (0.25% compared with 0.17%, r= - 0.45; p=0.162). The proportion of patients who died was larger among non-white patients (RR=9.10; CI95%= 1.83-45.23; p= 0.007) and lower among those treated with magnesium sulfate (RR=0.08; CI95%= 0.02-0.35; p= 0.001). CONCLUSIONS: the incidence of eclampsia among deliveries performed at the Sorocaba Hospital Compound decreased, although the disease still represents a significant cause of maternal death in the region. This study shows that it is essential that early diagnostic measures and treatment of preeclampsia and eclampsia be perfected by the health care system.

Eclampsia; Maternal mortality; Magnesium sulfate


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