الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
H
ypertensive disorders of pregnancy are a global cause of infant and mother mortality PE is defined as new-onset gestational hypertension SBP≥140 mmHg and/or DBP≥90 mmHg) associated with new-onset of at least one of proteinuria, maternal organ involvement), or utero placental dysfunction at or after 20 weeks’ gestation.
Eclampsia is currently defined as the occurrence of unexplained seizure during pregnancy in a woman with PE.
DEEG is a useful tool in the detection of CNS dysfunction during hypertensive pregnancy.
This study aims to know the role of DEEG in predication of eclampsia and early intervention to prevent eclampsia.
This study was Descriptive Observational case control study.
The sample consisted of 35 cases (24 PE, 11 eclampsia) and 35 controls (non pregnant women in childbearing period) in maternity hospital in Ain Shams University hospitals from august 2019 to august 2022.
Full medical history,seizure analysis(aura, semiology and postictal symptoms) and clinical examination were done for both cases and controls.
DEEG for 25 minutes was done for both cases and controls.
There were 28(80%) cases less than 25years and 7cases (20%) more than 25years, four cases(11.4%) with past history of HTN, 24 cases (68.6%) PE and11cases (31.4%) eclampsia and one case (2.9%) with past history of fits. There were not cases with past history of pre eclempsia, other neurological diseases and past history of occurring of fits during pregnancy.
There was a statistically significant difference between the studied groups regarding age > 25 yrs and past history of HTN. There was highly significant difference in findings in DEEG between cases and controls. There were 14(40.0%) cases (9 cases eclampsia,5 cases PE) with abnormal waves in from of parieto occpital polyspikes and slow waves, while in controls there was not abnormality.
The sensitivity of DEEG to detect preeclampsia and eclampsia was 40 % with specificity 100%.
There was highly significant difference in seizure, Sever HTN (SBP> 160 mm Hg and DBP> 110 mm Hg) and impaired consciousness between cases with DEEG finding and cases without DEEG finding. There was no statistically significant difference between cases with DEEG finding and cases without DEEG finding in age, headache, Visual symptoms and Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP syndrome).
In PE cases with abnormal finding in DEEG, the SBP was more than 160 mm Hg and DBP was more than 110 mm Hg), so PE cases with sever HTN are more risk to have brain insult.
While there was no statistically significant difference between control and patients group regarding past history of fits. There was no statistically significant difference between Findings in DEEG, age, past history HTN and past history of fits in patient group.
CONCLUSION
Hypertensive disorders of pregnancy (PE and eclampsia) can affect brain by increasing in BBB permeability to vasoactive substance and cerebral edema formation.
Theses effects can be detected by DEEG and neuroimaging (MRI brain).
DEEG changes may be present before occurrence of seizures.
These DEEG changes include parieto occpital polyspikes
and slow waves, so pregnant women with PE and eclampsia were found to be more liable to have abnormal DEEG waves with subsequent seizures especially with sever HTN (SBP> 160 mm Hg and DBP> 110 mm Hg).
The sensitivity of DEEG to detect preeclampsia and eclampsia was low (40 %).
RECOMMENDATION
Clinical recommendation
The use of DEEG as a simple non-invasive technique in theclinical evaluation of women with sever PE (sever HTN (SBP>160 mm Hg and DBP> 110 mm Hg), severe headache, epigastric pain and visual symptoms) to predict eclampsia is recommended
Serial DEEG may be needed in PE to monitor susceptibility to eclampsia
Research Recommendation
Further studies with larger sample size and longer duration of DEEG are needed to support the findings of the current study.
Neuroimaging (MRI brain) is needed with correlation with DEEG
.