1887
Volume 2002, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Objective: To measure the incidence and risk factors of eclampsia, establish how often it is preceded by preeclampsia, detect the clinical characteristics of women developing eclampsia, document the morbidity associated with eclampsia, determine the maternal case fatality rate and review the clinical features and management of this condition.

Method: A retrospective review of all cases of eclampsia which were managed in the Women's Hospital in the State of Qatar in the period between January 1991 to December 2000. Details were collected by reviewing the files of the patients from the medical record. Data were analyzed by either x2 analysis or the unpaired student “t” test as appropriate.

Result: Thirty nine cases of eclampsia were notified. The incidence of eclampsia in Qatar was 4.1 /10,000 maternities. Fourteen women (36%) had no antenatal care (ANC). However most convulsions occurred despite ANC (64%) and within one week of the woman's last visit to a doctor (58%). Thirty nine percent of the first seizures occurred in hospital, of which 23% developed before both proteinuria and hypertension had been developed. Twenty three percent of eclampsia occurred postpartum (PP), 51% antepartum (AP), and the remainder (26%) intrapartum (IP). There was no maternal fatality in Qatar but 23% of all women had at least one major complication. The rate of still birth (SB) andfirst week neonatal death (NND) was 76.2/1000 and 83.6/1000 respectively and the perinatal mortality rate (PNMR) was 153.8/1000. Preterm eclampsia was more common than term eclampsia (74% V 26%). Preterm eclampsia occurred more commonly AP (66%) and was associated with more maternal complications (26%) and fetuses that were small for gestational age (34%) as well as with higher rates of SB (10%) and first week NNDs (14%).

Conclusion: Eclampsia occurs in nearly one in 4000 maternities in Qatar and is associated with high incidence of maternal and neonatal morbidity and mortality. Antepartum onset carries greater risks and preterm eclampsia is particularly dangerous to both mother and fetus.

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2002-11-01
2024-03-29
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References

  1. Saflas AF, Olson Dr, Franks AL, Agash HR, Pogras R. Epidemiology of pre-eclampsia and eclampsia in the United States, 1979–1986. AmJ Obstet Gynecol. 1990; 163::460465.
    [Google Scholar]
  2. Leitch CR, Cameron AD, Walker JJ. The changing pattern of eclampsia over a 60 year period. Br J Obstet Gynecol. 1997; 104::917922.
    [Google Scholar]
  3. Douglas KA, Redman CW. Eclampsia in the United Kingdom. BMJ. 1994; 309::13951400.
    [Google Scholar]
  4. Cincotta R, Ross A. A review of eclampsia in Melbourne 1978-1992. AustNZJ Obstet Gynecol. 1996; 36:3:264271.
    [Google Scholar]
  5. World Health Organization collaborative study of hypertensive disorders of pregnancy. Geographic variation in the incidenceof hypertension in pregnancy. AmJ Obstet Gynecol. 1988; 158::8083.
    [Google Scholar]
  6. Lopez-Liera M. Main clinical types and subtypes of eclampsia. AmJ Obstet Gynecol. 1992; 166:49.
    [Google Scholar]
  7.   Which anticonvulsant for women with eclampsia ? Evidence from the collaborative Eclampsia Trial (Published erratum appears in Lancet 1995: 346: 258. Lancet. 1995; 345::14551463.
    [Google Scholar]
  8. Sibai BM, Eclampsia VI. Maternal – Perinatal outcome in 254 consecutive cases. AmJ Obstet Gynecol. 1990; 163:10–49:54.
    [Google Scholar]
  9. Pritchard JA, Cunningham FG, Pritchard SA. The Parkland Memorial Hospital Protocol for treatment of eclampsia: Evaluation of245 cases. AmJ Obstet Gynecol. 1984; 148::951963.
    [Google Scholar]
  10. Farid Matter, Baha M Sibai VIII. Risk factors for maternal morbidity. AmJ Obstet Gynecol. 2000; 182::307312.
    [Google Scholar]
  11. Geirsson R, Arngrionsson R, Apalset E, et al., Falling population incidence of eclampsia. Acta obstet Gynecol scand. 1994; 73::465467.
    [Google Scholar]
  12. Saftlas AF, olson DR, Franks AL, Atrash HK, Pokras R. Epidemiology of preeclampsia and eclampsia in the United States, 1979–1986. AmJ Obstet Gynecol. 1990; 163::460465.
    [Google Scholar]
  13. Miller B, Lindmark G. Echampsia in Sweden. Acta Obstet Gynecol Scand. 1986; 65::307314.
    [Google Scholar]
  14. Madsen H. Eklampsia, en retrospective undersogele of 14 eklampsitillfaelde. Ugeskr lacger. 1981; 143::37. (in Danish).
    [Google Scholar]
  15. Eeva Ekholm, Minna-Marja Salmi, Risto Erkkola. Eclampsia in Finland. Acta Obstet Gynecol Scand. 1999; 78::877882.
    [Google Scholar]
  16. Taner CE, Hakverdi AU, Aban M, Erden AC, Ozelbaykal U. Prevelance, management and outcome in eclampsia. International journal of Gynacology and obstetrics. 1996; 53::1115.
    [Google Scholar]
  17. Zuspan FP. Problems encountered in the treatment of pregnancy induced hypertension. AmJ Obstet Gynecol. 1978; 131::591.
    [Google Scholar]
  18. Sibai BM, Abdella TN, Spinnato JA. Eclampsia: The incidence of non preventable eclampsia. Am J obstet gynecol. 1986; 154::581.
    [Google Scholar]
  19. Altintas A, Aridogan N, Kadayifci O, Koker I, Ozden A. A study of572 cases with eclampsia and pre-eclampsia. Obstet gynecol. 1986; 2:3:123.
    [Google Scholar]
  20.   Evidence from the collaborative eclampsia trial. Which anticonvulsant for women with eclampsia? Lancet. 1995; 345::14531455.
    [Google Scholar]
  21. Lucas MJ, Leveno KJ, Cunningham FG. A comparison of Magnesium sulfate with phenytoinfor the prevention of eclampsia. N Eng J Med. 1995; 333::20205.
    [Google Scholar]
  22. Roberts JM, Redman CWG. Preeclampsia: more than pregnancy induced hypertension. Lancet. 1993; 341::14471451.
    [Google Scholar]
  23. Redman CWG, Roberts J. Management of preeclampsia. Lancet. 1993; 341::14511454.
    [Google Scholar]
  24. Weinstein L. syndrome of haemolysis, elevated liver enzymes, and low platelet count. A severe consequence of hypertension in pregnancy. AmJ Obstet Gynecol. 1982; 142::159167.
    [Google Scholar]
  25.  Department of Health, Welsh Office, Scottish Home and Health Department; Department of Health and Social Services, Northern Ireland. Report on confidential enquiries into maternal deaths in the United Kingdom 1985–1987. London: HMSO 1991.
    [Google Scholar]
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  • Article Type: Case Report
Keyword(s): Eclampsia in Qatar and Review
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