Miles J F, Martin J N, Blake P G, Perry K G, Martin R W, Meeks G R
Department of Obstetrics and Gynecology, University of Mississippi School of Medicine, Jackson.
Obstet Gynecol. 1990 Sep;76(3 Pt 1):328-31.
Because identification of patients at risk and preventive therapies are imperfect, eclamptic seizures continue to occur occasionally during the puerperium. During an 18-year span in a single tertiary medical center, 36 of 254 patients with eclampsia (14.2%) experienced postpartum seizures at a mean gestational age of 35.6 weeks. Early (before 48 hours) postpartum eclampsia was experienced by 72% of patients, and 28% had late (after 48 hours) postpartum eclampsia. Prospectively only 67% of patients were correctly diagnosed, and retrospectively only 83% could be considered to have had preeclampsia before seizure. Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome was present in 30% of the affected patients. Seven patients were receiving magnesium sulfate by controlled infusion when an eclamptic seizure occurred. The presence or absence of diuresis was unrelated to seizure occurrence. Preeclampsia recurred in 38.5% of subsequent gestations. It appears that HELLP syndrome may be a predisposing factor for eclampsia.
由于对高危患者的识别和预防性治疗并不完善，子痫抽搐在产褥期仍偶尔会发生。在一家三级医疗中心的18年期间，254例子痫患者中有36例（14.2%）在平均孕周35.6周时发生产后抽搐。72%的患者发生早期（48小时内）产后子痫，28%发生晚期（48小时后）产后子痫。前瞻性研究中只有67%的患者得到正确诊断，回顾性研究中只有83%的患者在抽搐前可被认为患有先兆子痫。30%的受影响患者存在溶血、肝酶升高和血小板计数降低（HELLP）综合征。7例患者在子痫抽搐发生时正在接受硫酸镁控制输注。利尿的有无与抽搐发生无关。38.5%的后续妊娠中先兆子痫复发。HELLP综合征似乎可能是子痫的一个诱发因素。
