Original Article

Is Eclampsia Preventable? A Case Control Review of Consecutive Cases from an Urban Underserved Region

Authors: Dotun Ogunyemi, MD, Jean-Louis Benae, MD, Chidi Ukatu, MD

Abstract

Objectives: The purpose of this study was to determine whether eclampsia is potentially preventable.


Methods: This was a retrospective case control study comparing 25 cases of eclampsia, 33 cases of preeclampsia and 50 pregnant controls. Eclampsia cases were classified as follows: group A was potentially preventable by patient education if there were preeclamptic symptoms before presenting to the hospital; group B was potentially preventable by health care provider if patient presented to health care with evidence of preeclampsia and was not appropriately treated; group C was not preventable if eclampsia developed without symptoms or preeclampsia. Statistical analysis was done as applicable.


Results: The mean gestational age at seizure was 34 weeks; 50% of seizures occurred outside a hospital and 44% had multiple seizures. Twenty were antepartum, three intrapartum, and two postpartum. Fourteen (56%) cases were classified as group A, 4 (16%) as group B and 7 (28%) as group C. Compared to controls, African-Americans, nulliparity, premature delivery, and increased neonatal morbidity were significantly associated with eclampsia. Compared with preeclamptics, eclamptic subjects had more symptomatology and more adverse maternal complications.


Conclusions: In this underserved population, a significant percentage of eclampsia cases are potentially preventable by patient education or health care response. In a smaller percentage, eclampsia may develop without any symptomatology or preeclampsia.

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