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Characterization of Symptoms Immediately Preceding Eclampsia

OBJECTIVE: To characterize the symptoms that immediately precede eclamptic seizures. METHODS: We did a prospective observational study of all women admitted to a single center in Tanzania between May 1, 2007 and April 30, 2008 who had an eclamptic seizure. During their admission they were asked a uniform set of questions related to symptoms preceding the seizure. RESULTS: There were 3,267 deliveries and 46 cases of eclampsia (1.4%). Neurologic symptoms (headache [80%] with or without visual disturbance [45%]) were the most common prodrome symptoms, regardless of degree of hypertension or whether the seizure occurred antepartum or postpartum. Twenty percent of women with eclampsia reported no neurologic symptoms before seizure. CONCLUSION: Neurologic symptoms commonly precede eclampsia. A minority of patients with eclampsia (17%) had no prodromal symptoms before their eclamptic seizure. Premonitory symptoms may provide an early warning of imminent eclampsia. LEVEL OF EVIDENCE: III