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.

Study Design 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).

Conclusion Over the study period, MgSO₄ has become the leading antiseizure medication used, and this has led to a significant decrease in rates of eclampsia.

Keywords

eclampsia - MgSO₄ - incidence - maternal mortality

Note

Presented at the 30th meeting of the Society of Fetal-Maternal Medicine, Chicago, Illinois, February 2010.

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