Journal Article

Maternal mortality due to eclampsia in Khyber Pakhtunkhwa: Identifying underlying risk factors, and care-seeking behaviours

Objective
To identify the characteristics of women at risk of death due to eclampsia, and steps to improve maternal outcome.

Methods
This study is a part of a retrospective study conducted in 2016 and included Mansehra, Swabi, Haripur, Nowshera, Kohat, and Dera Ismail Khan districts of the Khyber Pakhtunkhwa province of Pakistan, and used information cited by a 2016 study to estimate the maternal mortality rate in the province based on data pertaining to the 2013-14 period. The Maternal Death from Informants / Maternal Death Follow-on Review method was applied to identify the magnitude, causes and circumstances of maternal deaths in the province. SPSS 21 was used for data analysis.

Results
Of the 958 cases of maternal death identified, 167 (17%) were related to eclampsia. The median age of such women was 28 years (interquartile range: 11 years). Of them, 88 (53%) died undelivered, 48 (29%) had a live birth while 31 (18%) had a stillbirth or abortion. Mothers aged 25 years or above (p < 0.01), primiparous (p < 0.01) and those with a previous history of stillbirth (p < 0.005) carried higher risk, while higher socioeconomic status had a protective effect (p < 0.007).

Conclusions
Eclampsia deaths can be prevented through Continuum of Care approach and by ensuring provision of basic health facilities across the board.