title: Eclampsia: trends in incidence and outcomes over 30 years.
abstract: OBJECTIVE
  This study set out to describe the incidence, mortality rates, and treatment of eclampsia over a 30-year period in a large urban population.
  
  
  METHODS
  A detailed report of all pregnancies delivered in the Dublin area from 1977 to 2006 was reviewed for incidence, mortality, and treatment of eclampsia. Almost all pregnancies in this area are managed at one of three major obstetric hospitals. All offer comprehensive antenatal care and operate a restrictive policy to magnesium sulfate prophylaxis, in which MgSO4 is reserved for patients with severe preeclampsia or who have already had an eclamptic seizure.
  
  
  RESULTS
  During the 30-year study period, there were a total of 626,929 deliveries. Of the 247 cases of eclampsia (3.9/10,000 deliveries) and four maternal deaths (0.63/100,000 deliveries) attributed to eclampsia, none received MgSO4. The mortality rate due to eclampsia was 1.6% (4/247). The use of MgSO4 increased significantly from 11% (13/115) in the first decade of the study to 88.1% (67/76) in the last decade (p < 0.001). The incidence of eclampsia decreased from 5.4/10,000 in the first decade to 3.5/10,000 in the final decade of the study (p < 0.0001).
  
  
  CONCLUSIONS
  Over the study period, MgSO4 has become the leading antiseizure medication used, and this has led to a significant decrease in rates of eclampsia.
authors.affiliation: Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin, Ireland.
authors.forename: Hugh D
authors.initials: HD
authors.lastname: O'Connor
authors.forename: Mark P
authors.initials: MP
authors.lastname: Hehir
authors.forename: Etaoin M
authors.initials: EM
authors.lastname: Kent
authors.forename: Michael E
authors.initials: ME
authors.lastname: Foley
authors.forename: Chris
authors.initials: C
authors.lastname: Fitzpatrick
authors.forename: Michael P
authors.initials: MP
authors.lastname: Geary
authors.forename: Fergal D
authors.initials: FD
authors.lastname: Malone
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D015331:Cohort Studies; D004461:Eclampsia / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008428:Maternal Mortality / Q000639:trends*; D011225:Pre-Eclampsia / Q000188:drug therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014505:Urban Population
chemical_list: D000927:Anticonvulsants; D008278:Magnesium Sulfate