Is eclampsia preventable? A case control review of consecutive cases from an urban underserved region.
OBJECTIVE
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.
Ogunyemi
Dotun
D
Department of Obstetrics and Gynecology, Charles R. Drew University of Medicine & Science, University of California at Los Angeles, Los Angeles, CA 90059-3019, USA. doogunye@cdrewu.edu
Benae
Jean-Louis
JL
Ukatu
Chidi
C
D000328:Adult; D001741:Black or African American; D016022:Case-Control Studies; D004461:Eclampsia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D015141:Los Angeles; D008507:Medically Underserved Area; D011247:Pregnancy; D011256:Pregnancy Outcome; D011897:Random Allocation; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014505:Urban Population