Eclampsia in Sweden

OBJECTIVE: Assess the actual rate of eclampsia in Sweden, describe the clinical picture of the disease and the maternal and perinatal outcomes. METHODS: Analysis of data regarding incidence of eclampsia registered in the Swedish Medical Birth Register 1991-1992. The records of all the cases with the diagnosis of eclampsia in Sweden during 1991-1992 were retrospectively evaluated regarding maternal and fetal outcomes. RESULTS: The incidence of eclampsia after case review was 3.3/10,000 births. There was no maternal mortality. Severe maternal complications occurred in 30%. Recurrent fits were reported in 41%. Antenatal eclampsia was usually either not preceded by symptoms or signs of preeclampsia or by just a very short period of prodromal symptoms. Among intrapartum and postnatal cases of eclampsia, preeclampsia or high blood pressure was more frequently noted when convulsions occurred. Perinatal mortality rate was 4/80 (4.7%). Of the infants, 13% were small for gestational age. CONCLUSION: Compared with earlier studies, the incidence of eclampsia has increased significantly. It is questionable whether the incidence of eclampsia could be reduced by earlier diagnosis and treatment of preeclampsia. The risk of severe complications and recurrent fits was substantial, which underlines the importance of adequate treatment of eclampsia.