A review of eclampsia in Qatar 1991: 2000

Abstract EN

Objective : To measure the incidence and risk factors of eclampsia, establish how often it is preceded by pr-ec- lampsia, detect the clinical characteristics of women de¬veloping eclampsia, document the morbidity associated with eclampsia, determine the maternal case fatality rate and review the clinical features and management of this con¬dition.

Method : A retrospective review of all cases of eclamp¬sia which were managed in the Women’s Hospital in the State of Qatar in the period between January 1991 to De¬cember 2000.

Details were collected by reviewing the files of the patients from the medical record.

Data were ana¬lyzed 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 4.1110,000 ma¬ternities.

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 oc¬curred 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) and first week neonatal death (NND) was 76.2 / 1000and 83.6 / 1000respectively and the perinatal mor¬tality 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 weekNNDs (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.

An¬tepartum onset carries greater risks and preterm eclamp¬sia is particularly dangerous to both mother and fetus.