Clinical presentation of eclampsia in a Maternity Hospital, Kuwait

Objectives: To identify the clinical features of eclampsia at the time of the fit and to study the effects of eclampsia on neonatal outcome. Methods: A retrospective study of 101 patients with eclampsia in Al-Sabah Maternity Hospital of Kuwait between 1981 and 1993 was undertaken. Results: Seventy one percent of the mothers presented with antepartum eclampsia. Adverse perinatal outcome was associated with low gestation age, birth weight below 2500g and when the antepartum fit occurred >5 hours before delivery. The perinatal outcome was also adversely affected by fetal gender (male) and proteinuria of 2(+) or more. Conclusion: Early onset of pre eclamptic toxemia and eclampsia leading to early intervention are a major determinant to perinatal outcome and prematurity. Prompt timing of the delivery in cases of antepartum fit could help improve the neonatal outcome considerably. It seems that pre eclamptic toxemia is the major risk factor for eclampsia when compared with pregnancy induced hypertension. However, treating all cases of pre-eclampsia toxemia involves giving prophylaxis for more than 5% of all mothers per year. Therefore, one needs to study the details of cases of pre eclamptic toxemia and eclampsia to detect the additive factors. This would help to delineate guidelines and identify patients who need prophylaxis and the appropriate time for intervention.