Eclampsia: Likelihood Ratios

Introduction: Eclampsia is defined by seizures in pregnancy. Usually patients first develop pre-eclampsia, defined by hypertension and proteinuria. Treatment of pre-eclamptic patients with magnesium helps prevent eclampsia (and also, magnesium is the most effective treatment of eclamptic seizures).

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
All Pregnancies	0.00049%	BMJ 1994 Nov 26;309(6966):1395-400. PMID 7819845
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The likelihood ratios of findings for Eclampsia are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Uric Acid

2.1

0.4

serum uric acid >= 350mmol/l

Study: BJOG. 2006 Apr;113(4):369-78. PMID: 16553648

Poorly Diagnostic Findings

Finding	+LR	-LR	Comments, Study
Proteinuria	Sensitivity = 81%		Study: Am J Obstet Gynecol 1990 Sep;163(3):1049-54 PMID 2403130
Hypertension	Sensitivity = 79%		diastolic > 90mmHg Study: Am J Obstet Gynecol 1990 Sep;163(3):1049-54 PMID 2403130
Edema	Sensitivity = 68%		Study: Am J Obstet Gynecol 1990 Sep;163(3):1049-54 PMID 2403130
Headache, Vision Disturbance, or Epigastric Pain	Sensitivity = 59%		(antecedent) Study: BMJ 1994 Nov 26;309(6966):1395-400. PMID 7819845
Proteinuria and Hypertension	Sensitivity = 57%		so 57% had proteinuria+HTN at the last antenatal visit. Similarly, of those that had seizures in the hospital, only 62% had proteinuria+HTN when they arrived at the hospital initially. Study: BMJ 1994 Nov 26;309(6966):1395-400. PMID 7819845
Headache	Sensitivity = 50%		(antecedent) Study: BMJ 1994 Nov 26;309(6966):1395-400. PMID 7819845
Visual Disturbances	Sensitivity = 19%		(antecedent) Study: BMJ 1994 Nov 26;309(6966):1395-400. PMID 7819845
Epigastric Pain	Sensitivity = 19%		(antecedent) Study: BMJ 1994 Nov 26;309(6966):1395-400. PMID 7819845
Headache, Vision Disturbance, and Epigastric Pain	Sensitivity = 4%		(antecedent) Study: BMJ 1994 Nov 26;309(6966):1395-400. PMID 7819845