Eclampsia and Maternal Mortality in Ecuador
Keywords:
eclampsia; maternal mortality; hypertensive disorders of pregnancy; EcuadorAbstract
Background: Eclampsia is a severe manifestation of hypertensive disorders of pregnancy and a critical outcome associated with maternal morbidity, territorial inequity, and epidemiological measurement challenges in Ecuador.
Objective: To comprehensively examine the available evidence on eclampsia, hypertensive disorders of pregnancy, and maternal mortality in Ecuador, with emphasis on magnitude, territorial distribution, vulnerable subgroups, and diagnostic classification.
Methods: A qualitative systematic review without meta-analysis was conducted in accordance with PRISMA 2020. The search was performed in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, LILACS, and SciELO, covering publications from 2020 to 2025, in Spanish or English. Observational, population-based, or administrative studies in pregnant, intrapartum, or postpartum women with eclampsia, severe preeclampsia, HELLP syndrome, or hypertensive disorders of pregnancy were included. Two reviewers selected studies, and they integrated findings through narrative synthesis.
Results: A total of 124 potentially relevant records were identified, and 16 studies were included. The evidence showed heterogeneity in definitions, sources, and outcomes; associations with distance to obstetric care, altitude, type of care, and ethnicity; and difficulty estimating mortality attributable only to eclampsia because hypertensive diagnoses were often grouped.
Conclusions: Maternal mortality associated with eclampsia in Ecuador reflects the interaction between clinical severity, territorial inequality, access to critical obstetric care, and diagnostic variability. Studies need more precise definitions and comparable care-related variables.
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