Better Chances Of Preventing Seizures In Preeclampsia

Ten newly identified symptoms may indicate an increased risk of seizures (eclampsia) in pregnant women with preeclampsia. The findings could help reduce illness and death during pregnancy worldwide.

The work was led by researchers at the University of Gothenburg in Sweden, the University of Melbourne in Australia and Stellenbosch University in South Africa.

Eclampsia is a serious condition in which a pregnant woman develops seizures. It can be life-threatening and arises from preeclampsia. In Sweden, eclampsia is uncommon, but globally it still causes severe illness and death. Predicting who is at highest risk remains difficult, and current warning signs do not identify all women who go on to develop eclampsia.

Stronger clinical indicators

The study identifies ten symptoms strongly associated with eclampsia, including twitching in the arms or legs, impaired speech, confusion, changes in hearing, severe dizziness, and difficulty concentrating. These symptoms were uncommon among women with preeclampsia without eclampsia but were more frequently reported prior to seizures. Nearly all women with eclampsia experienced at least one symptom beforehand, and the risk increased with the number of symptoms present.

Lina Bergman, Associate Professor at Sahlgrenska Academy, University of Gothenburg, is one of the lead authors of the study:

"Today, it is difficult to determine who should receive preventive treatment with magnesium sulfate. With current clinical practice and the signs we rely on, we unfortunately miss most women who go on to develop eclampsia. The symptoms we have identified could help detect many more women who may benefit from treatment," says Lina Bergman.

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Magnesium sulfate can be used to reduce the risk of seizures, but it requires monitoring and is associated with side effect and is therefore not given to all women with preeclampsia. The newly identified symptoms may support more accurate clinical decision-making about who should receive treatment.

Women interviewed

The study included 2,142 women in Pakistan and South Africa: 341 had eclampsia, 1,355 had preeclampsia without eclampsia, and 389 had normotensive pregnancies. The researchers assessed symptoms in the days preceding a seizure or prior to the interview and compared responses across groups. The study is published in the journal PLOS Medicine.

The results show an association between the symptoms and eclampsia but do not establish causation. Because participants were asked retrospectively, some uncertainty remains.

The study was conducted by Lina Bergman at the University of Gothenburg, together with Stephen Tong, Professor at the University of Melbourne in Australia, and Catherine Cluver, Professor at Stellenbosch University in South Africa. They jointly led the work and contributed equally to the study.

Article: Identifying novel prodromal symptoms of eclampsia: a two-country, case-control study, PLOS Medicine.