A retrospective review of one hundred and seventy three cases of
eclampsia seen between 1994 and 2002 was conducted. Twenty one patients
(12.1%) whose ages ranged from 18 to 35 years sustained orofacial
injuries during the course of their eclamptic fits. Lacerations and
bruises on the tongue, gingivae and lips accounted for injuries in all
the patients. Temporomandibular joint dislocation was also recorded in
one patient. Tongue lacerations were mainly due to tongue biting.
Forceful insertion of objects during convulsive episodes was
responsible for the bruises and deep lacerations at the ventral surface
of the tongue in two patients. Two patients died from severe and
uncontrolled bleeding complicated by renal failure and aspiration
pneumonia from lacerations on the tongue and gingivae. Vigorous
campaign should be carried out to encourage antenatal care attendance
by pregnant mothers so that potential cases of eclampsia could be
nipped in the bud before progressing to frank eclampsia. Furthermore,
additional injuries usually inflicted on pregnant women by anxious
relatives from forceful insertion of unpadded objects as mouth props
should be discouraged through public health promotional campaigns.
Obstetricians should be aware of the possibility of these injuries in
an unconscious eclamptic patient and their life-threatening
consequences if not promptly diagnosed and managed. The need to seek
appropriate and early dental or maxillofacial consultation where such
injuries are suspected and where services are available is imperative.
(Afr J Reprod Health 2004; 8[3]:147-151