Objective To determine changes in the incidence and pattern of eclampsia within the same geographical area over a 60-year period.
Design A retrospective, descriptive study of 1259 consecutive women classified, at the time, as having had an eclamptic convulsion between the years 1931 and 1990.
Setting A large city centre teaching hospital and the surrounding catchment area.
Main outcome measures The changes in the incidence and timing of the convulsion and the outcomes for the mother and baby.
Results Over the study period, the incidence of eclampsia fell by more than 90%, from 74 1/10,000 in the 1930s to 7.2/10,000 in the 1980s.
Most of the reduction occurred over the first four decades, with little change in the last 20 years.
Overall, 44% of the cases of eclampsia occurred in the antenatal period, 33% intrapartum and 23% postpartum.
Since the biggest decreases were seen in the incidence of antenatal and particularly intrapartum eclampsia, there has been a relative increase in the proportion of eclampsia occurring postpartum.
Maternal death from eclampsia occurred in 15.1% of cases between 1931 and 1940,13.4% between 1941 and 1950, but fell dramatically to ¾3.9% after 1950.
There has been no maternal death since 1964.
Apart from the first decade, postpartum eclampsia was associated with significantly less risk of death to the mother throughout the study period.
Perinatal death rate has fallen steadily from 432. (...)
Mots-clés Pascal : Eclampsie, Epidémiologie, Evolution, Incidence, Homme, Femelle, Royaume Uni, Europe, Rétrospective, Gestation pathologie, Toxémie gravidique, Zone géographique
Mots-clés Pascal anglais : Eclampsia, Epidemiology, Evolution, Incidence, Human, Female, United Kingdom, Europe, Retrospective, Pregnancy disorders, Pregnancy toxemia
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0417291
Code Inist : 002B20F02. Création : 19/12/1997.