Abstract
Objective: To determine the prevalence of eclampsia in Qatar, the associated maternal and perinatal outcomes for the period from January 1991 to December 2009 and to define any possible preventive measures to this potentially fatal complication. Methods: A retrospective case review was performed of all women with eclampsia admitted to the Women's Hospital and Obstetrics and Gynecology department at Al Khor Hospital for the period from January 1991 to December 2009. Details were collected by reviewing the files of the patients from the medical records. Data were analyzed by either X2 analysis or the unpaired student “t” test as appropriate. Results: During the period of the study there were 224,809 births. Seventy women developed eclampsia (0.31/1000 deliveries), 44.3% of them were antepartum, 31.4% postpartum and 24.3% intrapartum eclampsia. 34.3% of patients presented with fits, 38.5% presented with pre-eclampsia (PE) and 20% presented with severe pre eclampsia; 18.5% were mild PE and another 27.2% were admitted with different complaints. Symptoms of impending eclampsia were seen in 22.9% of the PE patients. Thirty percent had no antenatal care (ANC). Antihypertensive therapy was given to 72% of cases. Antiepileptic therapy was administered to 48% of cases and 58.5% received magnesium sulfate. Eclampsia was associated with increased rate of cesarean section (CS) (64.2%). There was one maternal death, and the rate of major maternal complications was 20%. The perinatal mortality rate was 12.8%. Conclusion: The incidence of eclampsia in Qatar is 0.31 per 1000 deliveries. Although rare, this condition is associated with increased maternal morbidity and perinatal mortality. However our result is lower than reported worldwide. Improvement of obstetric care by having high index of suspicion even with apparently low risk patients, using magnesium sulfate prophylaxis for all cases of severe pre-eclampsia, in addition to community based approach to improve community health, education and prenatal care, all can be effective measures for the decrease incidence of this fatal condition although eclampsia cannot be entirely prevented.
Highlights
Eclampsia is an obstetric condition, which can present both to general and women's hospitals emergency departments.Eclampsia is the occurrence of one or more generalized convulsions and/or coma not caused by any co-incidental neurological disease, such as epilepsy, in a pregnant woman whose condition meets the criteria of pre-eclampsia.Pre-eclampsia/eclampsia remains the second most common cause of maternal death in the United States (US) and United Kingdom (UK) after thrombo-embolic disease.[1,2] Eclampsia accounts for 50,000 maternal deaths per year worldwide.[3]Eclampsia is rare before 20 weeks gestation, which should raise the possibility of an underlying molar pregnancy or antiphospholipid syndrome
Presented with pre-eclampsia (PE) and 20% presented with severe pre eclampsia; 18.5% were mild PE and another 27.2% were admitted with different complaints
This condition is associated with increased maternal morbidity and perinatal mortality
Summary
Eclampsia is an obstetric condition, which can present both to general and women's hospitals emergency departments.Eclampsia is the occurrence of one or more generalized convulsions and/or coma not caused by any co-incidental neurological disease, such as epilepsy, in a pregnant woman whose condition meets the criteria of pre-eclampsia (sustained protein uric hypertension with edema from 20 weeks gestation to the puerperium).Pre-eclampsia/eclampsia remains the second most common cause of maternal death in the United States (US) and United Kingdom (UK) after thrombo-embolic disease.[1,2] Eclampsia accounts for 50,000 maternal deaths per year worldwide.[3]Eclampsia is rare before 20 weeks gestation, which should raise the possibility of an underlying molar pregnancy or antiphospholipid syndrome. Eclampsia is an obstetric condition, which can present both to general and women's hospitals emergency departments. Eclampsia is the occurrence of one or more generalized convulsions and/or coma not caused by any co-incidental neurological disease, such as epilepsy, in a pregnant woman whose condition meets the criteria of pre-eclampsia (sustained protein uric hypertension with edema from 20 weeks gestation to the puerperium). Eclampsia is rare before 20 weeks gestation, which should raise the possibility of an underlying molar pregnancy or antiphospholipid syndrome. It is associated with high incidence of perinatal morbidity and mortality, which is mainly related to prematurity.[4]
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