Risk Factors of Eclampsia Other Than Hypertension: Pregnancy-Induced Antithrombin Deficiency and Extraordinary Weight Gain

Clinical features of isolated gestational proteinuria progressing to pre-eclampsia: retrospective observational study

“…Excessive weight gain during the final stage of pregnancy is suggested to be a risk factor for eclampsia 18. The daily protein loss in the urine was greater in women with P-PE than in those with O-PE, and the degree of proteinuria was inversely correlated with reductions of antithrombin activity and fibrinogen level in this study.…”

“…The net weight gains of 4.2 and 3.1 kg in the last 2 weeks and 1 week in women with P-PE accounted for approximately 34% and 25% of the total weight gain of 12.2 kg in pregnancy, respectively, while respective values of 1.6 and 1.3 kg in women with O-PE accounted for 12% and 9.6% of the total weight gain of 13.6 kg. As the mean±SD weekly weight gain, defined as (maternal weight at delivery−pre-pregnancy maternal weight)/(GW at delivery−2), is 0.26±0.12 kg for Japanese women with singleton pregnancies not complicated with pregnancy-induced hypertension,17 and weight gain in the last antenatal 2 weeks is 0.9±0.9 kg for otherwise healthy Japanese women with singleton pregnancies18; these results indicated that although oedema due to the accumulation of excess water in the interstitial space occurred in late pregnancy in P-PE and O-PE, its degree was greater in women with P-PE than in those with O-PE.…”

Risk factors for eclampsia in Japan between 2005 and 2009

“…In the present study, one-third of patients with eclampsia were registered as not having hypertension, indicating that the latter does not necessarily precede the development of the former. In a report of 11 patients with eclampsia [6], hypertension was not observed until the eclamptic fit in 1 case, was first observed on the day of the eclamptic fit in 5 cases, and was observed 1 day prior to the fit in 2 cases. Thus, there may be only a very short interval between the appearance of hypertension and the eclamptic fit in some patients, so hypertension may have been unrecognized or overlooked in some patients with eclampsia in the present study.…”

“…In studies from the UK [2,3] and Japan [4], gestational hypertension or preeclampsia was undiagnosed in approximately 20%-50% of women who went on to develop eclampsia. Because hypertension is usually recognized after an eclamptic fit [5], the duration of hypertension before the fit may be relatively short-as indicated in a small series of eclampsia cases [6] in which the interval between hypertension diagnosis and eclamptic fit was less than 7 days in all cases. This highlights the need to recognize risk factors other than hypertension in order to predict the development of eclampsia, and thereby prevent its occurrence.…”

Risk factors for postpartum hypertension in women with twin pregnancies

“…Thus, although not verifi ed to date, women with twin pregnancies may be more likely to develop eclampsia postpartum in the absence of long-lasting hypertension. Since severe hypertension is usually recognized after an eclamptic fi t [7] , the duration of hypertension prior to the eclamptic fi t may be relatively short Brought to you by | University of California Authenticated Download Date | 6/5/15 12:17 AM in the modern era, as suggested in a small series of eclampsia cases [17] in which the time interval after the diagnosis of hypertension until the eclamptic fi t was within 7 days in all 11 cases. Although whether hypertension necessarily precedes the eclamptic fi t irrespective of the duration of hypertension remains to be studied, hypertension precedes the eclamptic fi t in the majority of women [7,17] .…”