{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:58Z","timestamp":1787022178808,"version":"build-2736575974"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Hypertensive disorders of pregnancy remain a leading cause of preventable maternal and perinatal mortality, particularly in low\u2011 and middle\u2011income countries (LMICs). Eclampsia, the most severe manifestation, is responsible for a disproportionate share of maternal deaths in sub\u2011Saharan Africa, yet contemporary data from Tigray, Ethiopia are scarce.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the prevalence, clinical presentation, and factors associated with adverse feto\u2011maternal outcomes among women managed for eclampsia at Ayder Comprehensive Specialized Hospital (ACSH), Tigray, Ethiopia, between 1 January 2017 and 31 December 2021.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a retrospective cross\u2011sectional review of all women with a discharge diagnosis of eclampsia. A piloted extraction tool, adapted from recent studies, was used to abstract socio\u2011demographic, obstetric, clinical, laboratory, management, and outcome variables from medical charts. EpiData v4.6 was used for data entry, and data were analysed with Stata v16. Descriptive statistics summarised prevalence and presentation. Multivariate logistic regression identified independent predictors of (i) maternal end\u2011organ injury and (ii) perinatal death, reporting adjusted odds ratios (aOR) with 95% confidence intervals (CI). Model fitness was assessed with the Hosmer\u2013Lemeshow test (p\u2009>\u20090.05).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 23,090 deliveries during the study period, 252 women (1.1%, 95%\u00a0CI 1.0\u20131.2%) were diagnosed with eclampsia; 240 charts were analysed. The case\u2011fatality rate was 3.3% and perinatal mortality 20.1%. Antepartum eclampsia accounted for 63.8%, intrapartum 9.6%, and postpartum 26.7%. Headache (77.5%), visual disturbance (53.8%), and epigastric\/right\u2011upper\u2011quadrant pain (46.3%) were the most frequent prodromal symptoms. Independent predictors of maternal end-organ injury were referral from another facility (aOR 4.9, 95%\u00a0CI 1.8\u201313.9) and having perinatal death (aOR 2.7, 95%\u00a0CI 1.2\u20136.1). Vaginal delivery (aOR 5.5, 95%\u00a0CI 2.3\u201313.3), and pregnancies complicated with postpartum haemorrhage (aOR 3.2, 95%\u00a0CI 1.2\u20138.3), acute respiratory distress syndrome (aOR 3.2, 95%\u00a0CI 1.1\u20139.3), and dialysis\u2011requiring acute kidney injury (aOR 24.7, 95%\u00a0CI 5.6\u2013109.9) were independent predictors of perinatal death.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Eclampsia prevalence at ACSH remains high and is associated with substantial maternal and perinatal mortality. Strengthening antenatal surveillance, streamlining referral pathways, and ensuring timely definitive delivery are critical to improving outcomes. Context-specific quality\u2011improvement initiatives should prioritise the prevention and aggressive management of hypertensive disorders of pregnancy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0332620","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T17:32:42Z","timestamp":1759944762000},"page":"e0332620","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence, clinical presentations, and feto-maternal outcomes of eclampsia in a teaching hospital setting in Tigray region, Ethiopia: A five-year review"],"prefix":"10.1371","volume":"20","author":[{"given":"Rahel","family":"Kidanemariam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0968-4627","authenticated-orcid":true,"given":"Hale","family":"Teka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habtom","family":"Tadesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4556-2579","authenticated-orcid":true,"given":"Mohamedawel Mohamedniguss","family":"Ebrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephrem","family":"Berhe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bisrat Tesfay","family":"Abera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Abrha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8685-184X","authenticated-orcid":true,"given":"Hiluf Ebuy","family":"Abraha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awol","family":"Yemane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibrah","family":"Berhe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"pone.0332620.ref001","unstructured":"World Health Organization. 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