Report of 50 cases of eclampsia.

AIM: To ascertain the characteristics, clinical features, and maternal fetal outcome in eclampsia in a tertiary referral center with 24 000 deliveries per year.
METHODS: This is a cross-sectional study, in which 50 case notes were retrieved retrospectively and data was analyzed descriptively.
RESULTS: Eclampsia was significant in the Malay primipara patients (n = 14, P = 0.034) and the 20-24-year-old primipara patients (n = 11, P = 0.01). Most were significantly antepartum (64%) and preterm seizures (68%), and 16% were early onset (<31 weeks). Two-thirds were booked and one-third were inpatients. Twenty per cent did not have hypertension or pre-eclampsia antenatally. Most presented with headache (66%) and hyper-reflexia (48%). Only 16% presented with all three prodromal symptoms and 14% were asymptomatic. Half had diastolic blood pressure (DBP) of <110 mmHg and the level of DBP was not significantly associated with the presence of prodromal symptoms and signs. There was increased morbidity, operative intervention, admission to intensive care and more low birth weight babies. Most babies that weighed <2.5 kg had poor Apgar score at 1 min, but most babies had good Apgar score at 5 min (16 babies >2.5 kg, 22 babies < or =2.5 kg, P = 0.006). The corrected perinatal mortality was 40/1000.
CONCLUSION: There was increased maternal and perinatal morbidity but no maternal mortality. Contributing factors are the atypical presentation, early onset of disease and the absence of risk factors. There is a need to develop new methods to identify this group of patients in an effort to further reduce the prevalence of this dangerous condition.