Ducarme G, Herrnberger S, Pharisien I, Carbillon L, Uzan M
Service de chirurgie gynécologique et d'obstétrique, CHU Jean-Verdier, Assistance publique-Hôpitaux de Paris, université Paris-XIII, Bondy, France.
Gynecol Obstet Fertil. 2009 Jan;37(1):11-7. doi: 10.1016/j.gyobfe.2008.11.011. Epub 2008 Dec 31.
To determine the etiologic factors, circumstances of diagnosis, obstetrical management and complications of eclampsia and to value the maternal and perinatal outcomes.
We conducted a retrospective descriptive study, from January 1996 to December 2006 in a maternity type IIB.
Sixteen cases of eclampsia were studied. The prevalence of eclampsia over the study period was 8.1 per 10,000 births, without annual change in the incidence. The mean age of the patients was 27.8+/-6.7 years. The major risk factor was the primipaternity (87.5%). The eclampsia occurred in ante-, peri- and post-partum in 56, 6 and 38% of the cases, respectively. In cases of eclampsia, 75% of the patients had elevated blood pressure, 93% presented headache, but 62% presented with an atypical form with less than three functional symptoms (headache, visual trouble, hyperreflexia). Various treatments had been started: antihypertensive treatment (75%), antiepileptic treatment (69%) and magnesium sulphate (94%). Eleven patients had developed complications, mainly HELLP syndrome (10 patients). No maternal death was noted. The mean birth weight was 2366+/-818 g, 43.8% of children had birth weight less than the 10th percentile, and 87.5% of children were girls. One fetal and one perinatal death at day 19 had been noted.
Nowadays, the physiopathology of eclampsia remains misunderstood. It is difficult to establish risk factors, the primipaternity being certainly one of these. Eclampsia may occur in an atypical and unforeseeable form in well followed patients, without risk factor. The diagnosis should be done quickly for an adapted treatment and obstetrical management.
确定子痫的病因、诊断情况、产科处理及并发症，并评估孕产妇和围产儿结局。
我们于1996年1月至2006年12月在一家二级乙等产科进行了一项回顾性描述性研究。
研究了16例子痫病例。研究期间子痫的患病率为每10000例分娩中有8.1例，发病率无年度变化。患者的平均年龄为27.8±6.7岁。主要危险因素是初产（87.5%）。子痫分别发生在产前、产时和产后的病例占56%、6%和38%。子痫患者中，75%血压升高，93%有头痛症状，但62%表现为非典型形式，功能性症状少于三种（头痛、视觉障碍、反射亢进）。已开始采取各种治疗措施：降压治疗（75%）、抗癫痫治疗（69%）和硫酸镁治疗（94%）。11例患者出现并发症，主要是HELLP综合征（10例）。未记录到孕产妇死亡。平均出生体重为2366±818g，43.8%的儿童出生体重低于第10百分位数，87.5%的儿童为女孩。记录到1例胎儿死亡和1例出生后第19天的围产儿死亡。
如今，子痫的病理生理学仍未被完全理解。难以确定危险因素，初产肯定是其中之一。子痫可能以非典型且不可预见的形式发生在密切随访的患者中，且无危险因素。应迅速做出诊断以便进行适当的治疗和产科处理。
