Eclampsia in Kuwait 1981–1993

EDITORIAL COMMENT: We accepted this paper for publication because it provides interesting data concerning the incidence and clinical results obtained in 101 cases of eclampsia in 167,080 confinements in Kuwait. The vicissitudes of the Gulf war influenced the data gathering during this series but the results warrant comparison with those from an Australian teaching hospital shown in table A from 113,909 consecutive confinements. It should be noted that the overall similarity in results (apart from maternal mortality) is as remarkable as the dissimilarity in the methods used to treat women with preeclampsia and eclampsia in these 2 centres. The incidence of eclampsia was the same in Australia as Kuwait (5.6 versus 6 per 10,000 confinements). Nulliparas comprised 72% and 73% of the series respectively although it should be noted that in the Australian series nulliparas comprised 42% of the total obstetric population in comparison with 23% in Kuwait. The associations with multiple pregnancy (4.7% versus 5%) and diabetes (3.1% versus 2%) were similar as was the perinatal mortality rate (10.9% versus 9.3%), but not the maternal mortality rate (6.3% versus 1%) or the Caesarean section rate (25% versus 49%). We concur with most of the authors' conclusions but cannot agree that, in 1996, we can label eclampsia as a ‘preventable condition’. Summary: The aim of this study is to investigate the maternal and fetal outcome and the risk factors for developing eclampsia in Kuwait. The study includes all patients with eclampsia observed at the Maternity Hospital, Kuwait during the period from 1981 to 1993. It revealed that the risk factors predisposing to eclampsia were primiparity, a maternal age below 30 years, multiple pregnancy and the presence of preeclampsia. The pregnancy outcome in terms of the stillbirth rate, neonatal death rate and low birth‐weight babies was significantly higher in mothers with eclampsia than in noneclamptic mothers. The operative delivery and maternal mortality rates were also significantly higher in these patients.