Eclampsia: A 13-year experience at a United States tertiary care center

Eclampsia, the occurrence of a grand mal seizure in the setting of hyperten sion in pregnancy, remains a major women's health issue and an important ca use of maternal and fetal morbidity in the United States. We reviewed the i ncidence, management, and outcome of cases of eclampsia during a 13-year pe riod at a major maternity hospital. We confirmed 33 cases of eclampsia seen during that period and have evaluated risk factors in this population. Med ical records were reviewed to obtain demographic and clinical data. Charact eristics of the eclamptic women were compared with those of the general obs tetric population during the same time period. The overall incidence of ecl ampsia at this tertiary care center was 0.028%. The majority of eclamptic w omen (75%) had four or more prenatal visits. Young age (less than or equal to 20 years) and first pregnancy remained important risk factors for eclamp sia. Although many women with eclampsia had preceding hypertension or eleva ted urine protein levels or both, some experienced eclampsia as their first disease manifestation. Although the occurrence of eclampsia was low, eclam psia continues to complicate pregnancy in this large U.S. obstetric populat ion.