IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 1 Ver. IV (January. 2017), PP 49-54 www.iosrjournals.org DOI: 10.9790/0853-1601044954 www.iosrjournals.org 49 | Page A Comparative Study of Vaginal Delivery Versus Caesarean Section In Primigravida with Eclampsia After 34 Weeks of Pregnancy. Swaralipi Misra 1 ,Swapan Das 2 ,Debjani Deb 2 ,Biswajit Mahapatra 3 , Anindya Kumar Das 4 1 Post Graduate Trainee, Dept. Of Obstetrics & Gynaecology, Bankura Sammilani Medical College & Hospital, Bankura, West Bengal, India. 2 Assistant Professor, Dept. Of Obstetrics & Gynaecology, Bankura Sammilani Medical College & Hospital, Bankura, West Bengal, India. 3 RMO cum Clinical Tutor, Dept. Of Obstetrics & Gynaecology, Bankura Sammilani Medical College & Hospital, Bankura, West Bengal, India. 4 Professor, Dept. Of Obstetrics & Gynaecology, Bankura Sammilani Medical College & Hospital, Bankura, West Bengal, India. Abstract Objective : To compare the results of vaginal delivery & caesarean section in the management of antepartum eclampsia in primigravidae with more than 34 weeks by gestation, with reference to perinatal morbidity and mortality and maternal morbidity & mortality. Materials & Methods: This institution based, descriptive study was conducted in the department of obstetrics & Gynaecology, Bankura Sammilani Medicare College & Hospital, Bankura during the period extending from February 2014 to January 2015. A total 100 eclamptic women who fulfilled the inclusion criteria & had no factors mentioned in exclusion criteria were included in the study. Patients were divided into two groups for comparative analysis. The first group consisted of patients in whom conservative obstetric management and delivery per vaginum was carried out and was called the V.D. Group. The second group consisted of patients in whom lower segment caesarean section was carried out due to eclampsia and varied associated indications was called C.D. Group. Conclusion: Maternal & perinatal morbidity & mortality were low in patient undergoing caesarean delivery than in vaginal delivery group. Both maternal and perinatal outcome can be improved by taking an early decision for caesarean section when the cervix is unfavourable on admission or delivery is not anticipated within 6 hours. Keywords: Eclampsia, caesarean section, vaginal delivery. I. Introduction Eclampsia is a very serious complication of pregnancy responsible for high maternal and perinatal mortality. Eclampsia is a largely preventable condition and has becoming rare in developed countries. The term eclampsia is derived from a Greek word, meaning "like a flash of lightening". [1] The onset of convulsions in a woman with pre-eclampsia that cannot be attributed to other causes is termed eclampsia. [2] The incidence in India ranges from 1 in 500 to 1 in 30. It is more common in primigravidae (75%), five times more common in twins than in singleton pregnancies and occurs between the 36th week and term in more than 50% [1] Eclampsia is an obstetric enigma. Though it has almost been eradicated from the developed world, it continues to be a major cause of maternal and fetal mortality and morbidity in the developing countries. The real challenge of eclampsia has not been met. In spite of considerable progress made in the field of obstetrics, the incidence of eclampsia and its consequent complications has not decreased significantly in our country over the past few decades. It is indeed sad that even today antenatal care is available only to a fraction of our rural population. However, the management of eclampsia still poses a fascinating challenge to the obstetrician, requiring the greatest skill, judgement and patience. [3] Eclampsia is essentially a disease of low socio economic status of primigravida, a product of ignorance and neglect. Ideally, it is a preventable disease or almost so. But unfortunately its incidence is still uncomfortably high in any hospital accepting unbooked cases. Menon et.al (1989) quoted an incidence of 0.83% to 1.6% from leading centres of India. Faced with this reality, a plan of management has to be evolved. Though the exact patho-physiology leading to the occurrence of fits is still not understood, one thing has been proved beyond doubt that termination