A Review of Eclampsia in Qatar 1991: 2000

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.