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.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] Uric Acid	+ 0 -	2.1	0.4
serum uric acid >= 350mmol/l Study: BJOG. 2006 Apr;113(4):369-78. PMID: 16553648

Poorly Diagnostic Findings
Finding	Result	+LR	-LR
[ + ] 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