الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Eclampsia is the onset of seizures before, during, or after labor, which is not attributable to other causes and cannot be explained by any preexisting cerebral condition, in a woman with preeclampsia. Seizures must be accompanied by hypertension and proteinuria, within 24 hours of presentation to be considered eclampsia.
The aim of our study is to detect the possibility of normotensive eclampsia. Retrospective analysis of the files of patients admitted to Intensive Care Unit (ICU) of El Shatby hospital, with eclamptic fits from 1/1/2010 to 1/12/2010 were studied, they were 136 cases, divided into: Group I: antepartum fits )82 cases(, and group II: postpartum fits )54 cases(. They were studied by their age, gravidity and parity, gestational age, duration of ICU admission, mode of delivery, maternal complication, fetal outcome, blood pressure on admission and on discharge, medications and laboratory investigations.
The following positive findings were found: There were two cases detected in group I with antepartum fits with normal blood pressure on ICU admission, one of them received prophylactic Tamiflu which might cause seizures and behavioral changes and the other was explained as wrong measurement of blood pressure due to the altered circulatory dynamic state in eclampsia which could interfere with the production of the Korotokoff sounds, giving a false estimate of the blood pressure by conventional sphygmomanometry. Four cases detected in group II with postpartum fits. Two of those cases were referred from another hospital so they might receive antihypertensive drugs before referral especially that their blood pressure increased during their ICU stay. The other two cases, one of them had accidental hemorrhage and the other was with rupture uterus, so the bleeding might be the cause of their low blood pressure at the time of presentation. from the present study we concluded that, all our cases presenting on admission as normotensive during or after a fit, had high blood pressure during the period of ICU admission and all of them received antihypertensive drugs after delivery.
There were no significant differences between the two groups in most of the items except in the caesarian section deliveries, were significantly higher in group I than in group II, which is a logic mode of delivery to ensure the best outcome for a fetus of a convulsing mother, magnesium sulphate medication, which was significantly higher in group I than in group II, and HELLP syndrome complication was higher in group II.
There was a case detected with antepartum eclamptic fit at 16th week gestational age.
Maternal mortality was 4 cases in group I, and 3 cases in group II, while fetal mortality was 8 fetuses in group I, and 3 fetuses in group II.
Conclusion: The study concluded that, whenever antepartum or postpartum fit occurs without evident classical picture of pre-eclamptic toxemia; exclusion of other cause of convulsions is a must.