title: Eclampsia, a comparison within the International Network of Obstetric Survey Systems.
abstract: OBJECTIVE
  To compare incidences, characteristics, management and outcome of eclampsia in the Netherlands and the UK.
  
  
  METHODS
  A comparative analysis of two population-based prospective cohort studies.
  
  
  METHODS
  All hospitals with consultant-led maternity units.
  
  
  METHODS
  Women with eclampsia in the Netherlands (226) and the UK (264).
  
  
  METHODS
  Comparison of individual level data from national studies in the Netherlands and the UK (LEMMoN 2004-06; UKOSS 2005/06).
  
  
  METHODS
  Incidence, maternal complications and differences in management strategies.
  
  
  RESULTS
  Incidences of eclampsia differed significantly between both countries: the Netherlands 5.4/10,000 deliveries versus UK 2.7/10,000 (relative risk [RR] 1.94, 95% confidence intervals [95% CI] 1.6-2.4). The proportion of women with a preceding diagnosis of pre-eclampsia was comparable between both countries (the Netherlands 42%; UK 43%), as was the proportion who received magnesium sulphate prophylaxis. Women in the Netherlands had a significantly higher maximum diastolic blood pressure (111 mmHg versus 95 mmHg, P < 0.001); significantly fewer received anti-hypertensive medication (16% versus 71%; RR 0.2, 95% CI 0.1-0.3) and were treated less often with magnesium sulphate after their first fit (95% versus 99%; RR 0.96, 95% CI 0.92-0.99). Maternal death occurred in three cases in the Netherlands compared with zero in the UK.
  
  
  CONCLUSIONS
  The incidence of eclampsia in the Netherlands was twice as high compared with the UK when using uniform definitions. Women with eclampsia in the Netherlands were not managed according to guidelines, particularly with respect to blood pressure management. Changes in management practice may reduce both incidence and poor outcomes.
authors.affiliation: Department of Obstetrics, University Medical Centre Utrecht, Utrecht, the Netherlands.
authors.forename: T P
authors.initials: TP
authors.lastname: Schaap
authors.forename: M
authors.initials: M
authors.lastname: Knight
authors.forename: J J
authors.initials: JJ
authors.lastname: Zwart
authors.forename: J J
authors.initials: JJ
authors.lastname: Kurinczuk
authors.forename: P
authors.initials: P
authors.lastname: Brocklehurst
authors.forename: J
authors.initials: J
authors.lastname: van Roosmalen
authors.forename: K W M
authors.initials: KW
authors.lastname: Bloemenkamp
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D004461:Eclampsia / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D008278:Magnesium Sulfate / Q000627:therapeutic use; D009426:Netherlands / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000188:drug therapy; D011247:Pregnancy; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants; D000959:Antihypertensive Agents; D008278:Magnesium Sulfate
keywords: Eclampsia; INOSS; LEMMoN; Netherlands; UKOSS; United Kingdom