title: [Sixty-nine consecutive cases of eclampsia: prodromes and circumstances].
abstract: OBJECTIVE
  To specify clinical and biological characteristics of patients developing eclampsia, and identify atypical eclampsia without prior signs and symptoms of severe preeclampsia.
  
  
  METHODS
  This was a retrospective observational study conducted from January 1996 to December 2008 in a maternity type IIB in French Guiana. Data of patients who experienced eclampsia were collected from obstetric records.
  
  
  RESULTS
  Sixty-nine patients were selected among 21,525 patients who delivered during this period, corresponding to a prevalence of 3.2 ‰. The average patient age was 21 years (range from 12 to 45 years). Sixty-six percent of patients were nulliparous. The gestational age was greater than 37 weeks of gestation for 62% of patients, between 26 and 37 weeks of gestation for 36% and less than 26 weeks of gestation for 2% of patients. Two thirds of the patients had been examined less than a month before the eclamptic seizure, blood pressure was normal in 62% of cases. Seventy-four percent of patients had at least one Doppler study of the uterine and umbilical arteries velocimetry, the Dopplers studies were normal in 78% of cases. The eclampsia occurred in ante-, peri- and post-partum in 59, 6 and 35% of the cases, respectively 10% of patients were hospitalized for preeclampsia at the time of eclamptic seizure. Less than 10% of patients developed HELLP syndrome. One patient had died of aspiration pneumonia. Newborns had a mean birth weight over 2500 g in 88% of cases. During the follow-up period, 41% of the patients had subsequent pregnancies with 62% without hypertension, 24% complicated by recurrent gestational hypertension, 24% by preeclampsia and 4% by eclampsia.
  
  
  CONCLUSIONS
  In a majority of the patients in our study, eclampsia was the main manifestation, and only 10% were preceded by severe preeclampsia. These results are comparable to recent studies, which found in their series that 40 to 60% of eclampsia manifested without preeclamptic prodromi. Eclampsia can occur after an unremarkable pregnancy, in women without risk factors, and then it is hardly predictable. Prenatal follow-up must be very cautious paying attention to any markers such as intermittent hypertension, functional symptoms or appearance of proteinuria.
authors.affiliation: Service de gynécologie obstétrique, centre hospitalier de l'Ouest Guyanais, 16, boulevard du Général-Leclerc, BP 245, 94393 Saint-Laurent-du-Maroni, France. meluturck@yahoo.fr
authors.forename: M
authors.initials: M
authors.lastname: Turck
authors.forename: G
authors.initials: G
authors.lastname: Carles
authors.forename: W
authors.initials: W
authors.lastname: El Guindi
authors.forename: G
authors.initials: G
authors.lastname: Helou
authors.forename: N
authors.initials: N
authors.lastname: Alassas
authors.forename: M
authors.initials: M
authors.lastname: Dreyfus
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004461:Eclampsia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult