Main clinical types and subtypes of eclampsia

Abstract

Eclampsia has been traditionally divided in three types: antepartum, intrapartum, and postpartum. Several authors consider two more subtypes, early cases and intercurrent eclampsia. The clinical analysis of 990 patients with eclampsia divided according to such classification revealed numerous significant differences that could give grounds for the interpretation of conflicting results in medical research. Maternal and perinatal mortality, types and incidence of complications, obstetric and eclamptic profiles, and incidence of underlying diseases were strikingly higher in antepartum eclampsia, especially in early cases. The features of intrapartum eclampsia were closer to those of the postpartum group than to those of antepartum cases, and intercurrent eclampsia was oddly benign for the mother but not for the fetuses. These findings indicate that a more precise classification of eclampsia must consider seven differential facts: (1) timing of convulsions, (2) length of pregnancy, (3) complications , (4) underlying diseases, (5) maternal age, (6) number of index pregnancy, and (7) single or multiple gestation.