Eclampsia. V. The incidence of nonpreventable eclampsia.

The development of eclamptic convulsions is an obstetric complication that is generally considered to be avoidable. The purpose of this study was to investigate the perinatal events associated with 179 consecutive cases of eclampsia, in order to identify specific preventable factors. Based on a careful analysis of medical care received before the onset of eclampsia, the following factors were judged to be at least partially responsible for the failure to prevent eclamptic convulsions: physician error (n = 65), magnesium sulfate failure (n = 23), late-onset eclampsia (n = 22), early onset (less than 21 weeks) preeclampsia/eclampsia (n = 5), abrupt onset eclampsia (n = 32), and failure of patient to start prenatal care before the onset of eclampsia (n = 34). Fifty-six (31.3%) of the patients received obstetric care that met or exceeded all current standards for delivery of obstetric services. These cases were classified as "unavoidable."