Thrombocytopenia, hypertension and seizures in eclampsia.

OBJECTIVE

Mortality by eclampsia most likely relies on factors that are associated with seizures, but not directly related to them. The objective of the current study is to analyze these probable factors.

METHODS

This study evaluates patients with eclampsia only. Age, parity, weeks of gestation, blood pressure, platelet counts and cause of death were analysed. The groups of survivors and fatalities were compared using relative risk (RR) with 95% confidence intervals (CI), chi2 and Student's t-test.

RESULTS

A total of 446 cases of eclampsia were studied, of which there were 371 survivors and 75 deaths. The incidence was 14.2/10000 births with mortality of 14.4%. Mortality was more frequent in patients over 25 years of age (P < 0.005). The diastolic blood pressure showed significant difference between the survivor and fatality group (P < 0.05). Before convulsion, thrombocytopenia was present in 148 patients (33.2%) of which 95 survived and 53 died (RR = 2.76; 95% CI 2.20-3.46; P < 0.0000001).

CONCLUSIONS

Mortality by eclampsia is directly related to age, diastolic blood pressure > or = 110 mmHg, seizure and thrombocytopenia. Our findings suggest poor maternal prognosis if seizures occur associated with thrombocytopenia.