Doctors on a drive to map disease that kills mothers

Eclampsia,the cause of around 15 per cent maternal mortality in the country,is being mapped,to be nipped in the bud.

Written by Jinal Shah | Mumbai | Published: February 7, 2009 1:57:18 am

Responsible for 15% of maternal deaths,yet neglected so far

Eclampsia,the cause of around 15 per cent maternal mortality in the country,is being mapped,to be nipped in the bud. Taking the initiative is the Federation of Obstetrics and Gynecologists Societies of India (FOGSI),which has started a national registry of eclampsia.

Despite being one of the leading causes,along with bleeding and anemia,of maternal mortality rate (MMR) in the country,eclampsia has not yet been tackled seriously.

“Of the 78,000 maternal deaths every year in the country,15 percent is due to eclampsia. This can be prevented,” said Dr Sanjay Gupte,National coordinator,National Eclampsia Registry at FOGSI.

One reason for eclampsia not being taken seriously so far is lack of awareness. Eclampsia,defined as “a seizure or coma unrelated to other cerebral conditions in an obstetrical patient with pre-eclampsia” is seen in early and late pregnancies. It can affect all strata of society but the frequency is more in the lower economic strata.

Since doctors usually do not know the high prevalence rate and it is not really talked about,treatment procedures are also ignored. “Doctors from all 120 nodal centers of FOGSI have started sending reports on eclampsia. They will report cases in nearby areas too. This may include both government and private hospitals,” said Dr Gupte,a practising gynecologist in Pune.

“The registry will help a lot in not just collecting information on deaths due to eclampsia but also revising treatment guidelines and preventing deaths by early detection,” he added.

Worldwide,eclampsia accounts for approximately 50,000 maternal deaths annually. In the United States,the MMR due to eclampsia has been reduced,with early diagnosis and aggressive management. It is now less than 1 percent. The foetal mortality rate from eclampsia has also decreased but still remains at approximately 12%.

“In the United Kingdom in the 1970s they started maintaining a registry and worked by statistics available,which helped. Death due to eclampsia has been reduced almost to 1 percent,” said Dr Gupte.

Registry is part of an awareness campaign and helps in identifying and treating the disease. “Low-cost drug magnesium sulphate is available in the market (not a government scheduled drug) to help stabilise the patient until a specialized doctor is consulted. It is also available in injectable form and can be given even by a nurse in times of emergency,” he added.

“Since it is a voluntary initiative,there are loopholes and there could be overlapping of cases reported. But we are trying to address the issue,” said Dr Gupte.

Last week,FOGSI doctors met the health minister to discuss the alarming MMR in Maharashtra and the minister assured them that doctors in government hospitals will share details of maternal deaths due to eclampsia. “Both the state and the central health ministry have records of MMR. However they do not have detailed record of the disease or disorder causing it,” said Dr Gupte.

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