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.

Fluid Test

Hypertension

Sensitivity = 79%

diastolic > 90mmHg

Study: Am J Obstet Gynecol 1990 Sep;163(3):1049-54 PMID 2403130

History

Headache

Sensitivity = 50%

(antecedent)

Study: BMJ 1994 Nov 26;309(6966):1395-400. PMID 7819845

Hypertension

Sensitivity = 79%

diastolic > 90mmHg

Study: Am J Obstet Gynecol 1990 Sep;163(3):1049-54 PMID 2403130

Physical Exam

Hypertension

Sensitivity = 79%

diastolic > 90mmHg

Study: Am J Obstet Gynecol 1990 Sep;163(3):1049-54 PMID 2403130

Toxic

Hypertension

Sensitivity = 79%

diastolic > 90mmHg

Study: Am J Obstet Gynecol 1990 Sep;163(3):1049-54 PMID 2403130

Urine Test

Proteinuria

Sensitivity = 81%

Study: Am J Obstet Gynecol 1990 Sep;163(3):1049-54 PMID 2403130

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Finding	+LR	-LR	Comments, Study
Edema	Sensitivity = 68%		Study: Am J Obstet Gynecol 1990 Sep;163(3):1049-54 PMID 2403130
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
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
Uric Acid	2.1	0.4	serum uric acid >= 350mmol/l Study: BJOG. 2006 Apr;113(4):369-78. PMID: 16553648
Visual Disturbances	Sensitivity = 19%		(antecedent) Study: BMJ 1994 Nov 26;309(6966):1395-400. PMID 7819845