Identifying novel prodromal symptoms of eclampsia: A two-country, case-control study

by Roxanne Hastie, Farhatulain Ahmed, Parinaz Mehdipour, Bernard Yan, Susan P. Walker, Jacqui Visser, Anam Bashir, Lyle Gurrin, Anthea Lindquist, Jessica A.

Atkinson, Catherine Cluver, Lina Bergman, Stephen Tong Background Magnesium sulphate halves the risk of eclampsia. There is no consensus on who to give magnesium sulphate prophylaxis because clinical tools are poor at identifying those at risk.

Known prodromal symptoms such as headache, visual disturbance, or epigastric pain have modest associations with eclampsia. We set out to identify new prodromal symptoms of eclampsia.

Methods and findings This case-control study prospectively recruited participants in South Africa and Pakistan who had eclampsia, preeclampsia, or normotensive pregnancies. We asked whether they experienced 20 neurological symptoms, within 7 days of the seizure for those who had eclampsia.

The primary analysis was the likelihood of symptoms occurring before eclampsia, compared to being present with preeclampsia.341 participants were recruited with eclampsia, 1,355 with preeclampsia and 389 with normotensive pregnancies.