Better prospects for preventing seizures in pre-eclampsia

The study was led by researchers at the University of Gothenburg in collaboration with colleagues from the University of Melbourne, Australia, and Stellenbosch University, South Africa. 

Eclampsia is a serious condition in which a pregnant woman experiences seizures. The condition, which can be life-threatening, develops from pre-eclampsia, a pregnancy complication characterised by high blood pressure and other systemic effects.

Although eclampsia is rare in Sweden, it remains a major cause of severe illness and death globally. Identifying in advance which women are at greatest risk has been a longstanding challenge.

The researchers identified ten previously under-recognised symptoms that were strongly associated with eclampsia. These included involuntary jerking movements in the arms or legs, speech disturbances, confusion, changes in hearing, severe dizziness and difficulty concentrating.

The symptoms were uncommon among women with pre-eclampsia who did not develop eclampsia, but frequently occurred before seizures in women who went on to develop the condition. Almost all women with eclampsia reported at least one symptom beforehand, and the risk increased markedly with the number of symptoms present.

“One of the challenges today is determining who should receive preventive treatment with magnesium sulphate,” says Lina Bergman, Senior Specialist/Chief Physician in obstetrics at Sahlgrenska University Hospital and Docent at the Sahlgrenska Academy, University of Gothenburg.

“With current clinical practice and the warning signs we typically look for, we unfortunately miss most women who go on to develop eclampsia. The new symptoms we have identified could help us identify many more women who may benefit from treatment.”

Magnesium sulphate is used to reduce the risk of seizures, but because the treatment requires monitoring and may cause side effects, it is not routinely given to all women with pre-eclampsia. The newly identified symptoms could contribute to a more accurate assessment of who is most likely to benefit.

The study included 2,142 women in Pakistan and South Africa. Of these, 341 had eclampsia, 1,355 had pre-eclampsia without seizures, and 389 had uncomplicated pregnancies. Researchers asked participants about symptoms experienced in the days before a seizure or before the interview and compared responses between the groups. The study has been published in PLOS Medicine.

The findings demonstrate a strong association between these symptoms and eclampsia, although they do not establish that the symptoms cause the condition. As participants were asked to recall symptoms retrospectively, some uncertainty remains regarding the responses. 

Source: University of Gothenburg