Eclampsia in the United Kingdom - PubMed (original) (raw)
Eclampsia in the United Kingdom
K A Douglas et al. BMJ. 1994.
Abstract
Objectives: To measure the incidence of eclampsia, establish how often it is preceded by signs of pre-eclampsia, document the morbidity associated with eclampsia, and determine the maternal case fatality rates.
Design: A prospective, descriptive study of every case of eclampsia in the United Kingdom in 1992. Information was collected from reviews of hospital case notes and questionnaires to general practitioners.
Setting: All 279 hospitals in the United Kingdom with a consultant obstetric unit.
Results: Obstetricians and midwives notified 582 possible cases, and 383 were confirmed as eclampsia. The national incidence of eclampsia was 4.9/10,000 maternities (95% confidence interval 4.5 to 5.4). Most convulsions occurred despite antenatal care (70%) and within one week of the woman's last visit to a doctor or midwife (85%). Three quarters of first seizures occurred in hospital, of which 38% developed before both proteinuria and hypertension had been documented. Forty four per cent of cases occurred postpartum, more than a third (38%) antepartum, and the remainder (18%) intrapartum. Nearly one in 50 women (1.8%) died, and 35% of all women had at least one major complication. The rate of stillbirths and neonatal deaths was 22.2/1000 and 34.1/1000, respectively. Preterm eclampsia occurred more commonly antepartum and was associated with more maternal complications and fetuses that were small for gestational age, as well as with higher rates of stillbirth and neonatal mortality. Antepartum eclampsia, which was more likely to occur preterm, was associated with a higher rate of maternal complications and a higher neonatal mortality. Both factors (gestational prematurity and antepartum occurrence) contributed independently to the severity of the outcome.
Conclusion: Eclampsia occurs in nearly one in 2000 maternities in the United Kingdom and is associated with high maternal morbidity and fatality in cases. It may present unheralded by warning signs. Preterm and antenatal eclampsia seem to be particularly severe.
Comment in
- Eclampsia in the United Kingdom. Better standards of care will reduce morbidity and mortality.
O'Donnell E, Somerset D. O'Donnell E, et al. BMJ. 1995 Apr 29;310(6987):1137-8. doi: 10.1136/bmj.310.6987.1137c. BMJ. 1995. PMID: 7605469 Free PMC article. No abstract available. - Eclampsia in the United Kingdom. More information is required.
Daniel DG, Golding RH. Daniel DG, et al. BMJ. 1995 Apr 29;310(6987):1137; author reply 1138. doi: 10.1136/bmj.310.6987.1137b. BMJ. 1995. PMID: 7742693 Free PMC article. No abstract available.
Similar articles
- Management of eclampsia in the accident and emergency department.
Munro PT. Munro PT. J Accid Emerg Med. 2000 Jan;17(1):7-11. doi: 10.1136/emj.17.1.7. J Accid Emerg Med. 2000. PMID: 10658982 Free PMC article. Review. - Epidemiology of eclampsia in Colombia.
Conde-Agudelo A, Kafury-Goeta AC. Conde-Agudelo A, et al. Int J Gynaecol Obstet. 1998 Apr;61(1):1-8. doi: 10.1016/s0020-7292(98)00003-4. Int J Gynaecol Obstet. 1998. PMID: 9622165 - Maternal and perinatal mortality due to eclampsia.
Swain S, Ojha KN, Prakash A, Bhatia BD. Swain S, et al. Indian Pediatr. 1993 Jun;30(6):771-3. Indian Pediatr. 1993. PMID: 8132257 - Pregnancy outcome in eclamptics at the University of Abuja Teaching Hospital, Gwagwalada, Abuja: a 3 year review.
Agida ET, Adeka BI, Jibril KA. Agida ET, et al. Niger J Clin Pract. 2010 Dec;13(4):394-8. Niger J Clin Pract. 2010. PMID: 21220852 - Diagnosis, prevention, and management of eclampsia.
Sibai BM. Sibai BM. Obstet Gynecol. 2005 Feb;105(2):402-10. doi: 10.1097/01.AOG.0000152351.13671.99. Obstet Gynecol. 2005. PMID: 15684172 Review.
Cited by
- Earlier onset of proteinuria or hypertension is a predictor of progression from gestational hypertension or gestational proteinuria to preeclampsia.
Morikawa M, Mayama M, Noshiro K, Saito Y, Nakagawa-Akabane K, Umazume T, Chiba K, Kawaguchi S, Watari H. Morikawa M, et al. Sci Rep. 2021 Jun 16;11(1):12708. doi: 10.1038/s41598-021-92189-w. Sci Rep. 2021. PMID: 34135442 Free PMC article. - Diagnostic accuracy of urinary spot protein:creatinine ratio for proteinuria in hypertensive pregnant women: systematic review.
Côté AM, Brown MA, Lam E, von Dadelszen P, Firoz T, Liston RM, Magee LA. Côté AM, et al. BMJ. 2008 May 3;336(7651):1003-6. doi: 10.1136/bmj.39532.543947.BE. Epub 2008 Apr 10. BMJ. 2008. PMID: 18403498 Free PMC article. Review. - Comparison of gestational diabetes mellitus and pre-eclampsia in women with high hemoglobin in the first trimester of pregnancy: A longitudinal study.
Mehrabian F, Hosseini SM. Mehrabian F, et al. Pak J Med Sci. 2013 Jul;29(4):986-90. doi: 10.12669/pjms.294.4012. Pak J Med Sci. 2013. PMID: 24353673 Free PMC article. - Quantifying the fall in mortality associated with interventions related to hypertensive diseases of pregnancy.
Ronsmans C, Campbell O. Ronsmans C, et al. BMC Public Health. 2011 Apr 13;11 Suppl 3(Suppl 3):S8. doi: 10.1186/1471-2458-11-S3-S8. BMC Public Health. 2011. PMID: 21501459 Free PMC article. Review. - Headache and seizure on postpartum day 5: late postpartum eclampsia.
Ginzburg VE, Wolff B. Ginzburg VE, et al. CMAJ. 2009 Feb 17;180(4):425-8. doi: 10.1503/cmaj.071446. CMAJ. 2009. PMID: 19221357 Free PMC article. No abstract available.
References
- Lancet. 1993 Jun 5;341(8858):1447-51 - PubMed
- Int J Technol Assess Health Care. 1992;8 Suppl 1:75-81 - PubMed
- Br J Obstet Gynaecol. 1992 May;99(5):355-6 - PubMed
- Am J Obstet Gynecol. 1992 Jan;166(1 Pt 1):4-9 - PubMed
- Am J Obstet Gynecol. 1990 Aug;163(2):460-5 - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources