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Researchers identify ten early symptoms linked to eclampsia in pregnancy, offering a way to predict and prevent life-threatening seizures with timely treatment
Ten previously unrecognised warning signs could help doctors identify pregnant women at risk of eclampsia, a rare but potentially fatal condition that can trigger severe seizures.
A new international study suggests symptoms such as twitching limbs, confusion, and severe dizziness may appear before seizures occur, creating a critical opportunity for preventive treatment.
What is eclampsia in pregnancy?
Eclampsia causes pregnant women to develop seizures and is a serious complication of preeclampsia. It remains a major cause of severe illness and death during pregnancy and remains difficult to predict who is at most risk, often occurring without any warning signs.
Eclampsia is uncommon in countries with well-developed health systems, but in low- and middle-income countries, eclampsia in pregnancy occurs in around 50-150 cases per 10,000 deliveries.
Lina Bergman, researcher at the University of Gothenburg, Sweden: “Currently, it is difficult to determine who should receive preventive treatment with magnesium sulfate. Using the clinical signs available today, we miss many women who later develop eclampsia. The symptoms we have now identified could make it possible to detect more cases in time.”
What are the ten symptoms?
The researchers identified ten symptoms strongly associated with eclampsia in pregnancy:
Twitching in arms or legs
Impaired speech
Confusion
Impaired hearing
Severe vertigo (intense dizziness)
Difficulty concentrating
Severe headache
Visual disturbances (e.g. blurred vision)
Nausea or vomiting
Epigastric pain (upper abdominal pain, under the ribs)
Study suggests early symptoms could flag eclampsia risk, but evidence is not yet causal
The researchers analysed health data from 2,142 women in Pakistan and South Africa: 341 had eclampsia, 1,355 had preeclampsia without seizures, and 389 had normotensive pregnancies.
The team assessed symptoms in the days preceding a seizure or, for the other groups, before the interview, and compared responses across groups. The results show a clear association between the symptoms and eclampsia, but do not establish causation. Because participants were asked retrospectively, the findings may be subject to some uncertainty. Other limitations include reliance on self-reported symptoms, which may be affected by recall bias, and a limited study sample to two countries, which could affect generalisability.
Stephen Tong, Professor, University of Melbourne, Australia: “The symptoms currently used, such as headache and visual disturbances, show relatively weak associations with eclampsia. Here, we see symptoms with substantially stronger links, which could better inform clinical decision-making.”
Catherine Cluver, Professor, Stellenbosch University, South Africa: “Eclampsia is rare in some parts of the world but remains a major global problem. Being able to identify women at risk earlier could have a significant impact, particularly in settings with limited access to advanced care.”
The full study is available in PLOS Medicine.