Time to recovery from Eclampsia and its determinants in east Gojjam zone hospitals, Amhara, Ethiopia, 2017/18

Kassie et al. BMC Pregnancy and Childbirth https://doi.org/10.1186/s12884-021-03769-7 (2021) 21:301 RESEARCH ARTICLE Open Access Time to recovery from Eclampsia and its determinants in east Gojjam zone hospitals, Amhara, Ethiopia, 2017/18 Bekalu Kassie1*, Yibelu Bazezew1, Yewbmirt Sharew1, Leltework Yismaw2, Melaku Desta1 and Muluneh Alene2 Abstract Background: Eclampsia is a tonic clonic type of seizure among pre-eclamptic mothers. Time to recovery from eclampsia is to mean that the time when the mother recovered from severity features of pre-eclampsia. As far as the mother is not free from severity features, she is in a potential to end-up with repeated seizure (eclampsia). Therefore, combating eclampsia through controlling severity features is crucial to enhance maternal health quality, reduce maternal morbidity and mortality, and improve prenatal outcomes. There was no literature that describes the recovery time of eclampsia and its determinants in Ethiopia. Therefore, this study aimed to assess the recovery time from eclampsia and its determinants in East Gojjam zone hospitals. Methods: An institutional based retrospective follow up study was conducted between January 2014 and December 2017 among 608 eclamptic mothers in East Gojjam zone Hospitals. Simple random sampling technique was used. Data were coded and entered to Epidata version 3.1 and was exported to SPSS version 20 and then to Stata 14. We used the adjusted hazard ratio (AHR) with 95% confidence interval at p-value less than 0.05 to measure strength of association. Result: The median recovery time of eclampsia was 12 h with inter-quartile range of (1–48 h). The rate of recovery from eclampsia among mothers aged more than 20 years was reduced by half (AHR 0.50 (0.28, 0.89)) than the teenagers. The rate of recovery from eclampsia among mothers who had prolonged labor was 1.3 times (AHR 1.26 (1.01, 1.57)) than those whose labor was less than 12 h. About 32% of mothers with multiple convulsions recoverd later than (AHR 0.68 (0.52, 0.87)) those who had single convulsion. As compared to antepartum convulsion, the rate of recovery from postpartum eclampsia was 1.8 times faster (AHR 1.81(1.17, 2.81)). Conclusion: The median recovery time from severity features among eclamptic mothers in East Gojjam zone hospitals was half a day. It is affected by age, duration of labor, number of convulsions and time of occurrence of the event. Special attention for elders, prevent recurrent convulsion and faster termination for the antepartum eclamptic mothers are recommended from this follow-up study. Keywords: Eclampsia, Pregnancy induced hypertension, Time to recovery, East Gojjam, Ethiopia * Correspondence: 1 Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia Full list of author information is available at the end of the article © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Kassie et al. BMC Pregnancy and Childbirth (2021) 21:301 Introduction Improving maternal and child health is a global priority [1] .The problem of maternal health during pregnancy is one with many special features as maternity is not a disease. Pregnancy and childbirth are privileged functions of women, essential for the survival of our species which is not being compared with other burdens of disease [2]. Maternal mortality is a key indicator of international development, and its reduction has long been a challenge in low-income countries, despite the existence of effective interventions [3]. Pregnancy and childbirth related complications are common problems that cause many women to die and suffer life-threatening difficulties that disable them [4–6]. Even if most of maternal deaths are preventable, maternal mortality rate is still high and it is the major public health problem in the world, especially in developing countries [7–9]. Globaly in the past two and a half decades, there was a significant progress in the declining maternal mortality [4, 5, 7]. In spite of this improvement, more than 289,000 women still die each year as a result of pregnancy and childbirth through pregnancy to the first 42 days of the postpartum period globally [4, 5, 7, 9]. Nearly all of these women live in poor nations where 99% of the global maternal death has been occurring in developing countries, mainly in the two developing regions, sub-Saharan Africa and southern Asia [5, 7]. Eclampsia is the development of generalized grandmal tonic clonic convulsions in a pregnant or puerperal woman, usually between 20 weeks’ of gestation and the first 48 h of postpartum period, mostly in a woman with gestational hypertension or preeclampsia in the absence of other neurologic conditions [10, 11]. It is the most devastating type of Hypertension Disorders of pregnancy (HDP) [10]. Hypertensive disorders during pregnancy remains a significant public health problem throughout the world, and eclampsia is one of the most life-threatening complications of these disorders. HDP accounts for nearly 18% of all maternal deaths worldwide, with an estimated 62,000–77,000 deaths per year (18). Eclampsia is a major health problem in developing countries and every year, eclampsia is associated with an estimated 50,000 maternal deaths Worldwide [12]. Around 70% of mothers with eclamsia develop life threatening complications which include abruption placentae, disseminated intravascular coagulopathy, acute renal failure, hepatocellular injury, liver rupture, intracerebral hemorrhage, transient blindness, cardio respiratory arrest, aspiration pneumonitis, acute pulmonary edema, postpartum hemorrhage and HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelet counts). Page 2 of 9 Ethiopia, is one of the six countries which has highest Maternal Mortality Ratios (MMR) in the world and currently, the Ethiopian MMR is 420/100,000 live births [13]. Most causes of these deaths are preventable including eclampsia. In Ethiop (...truncated)