Eclampsia at Harare Maternity Hospital. An epidemiological study.

Physicians at the Harare Maternity Hospital in Zimbabwe treated 34 women with eclampsia in 1982. 25 of these women lived within the Greater Harare Obstetric Unit (GHU) which included the hospital and 13 maternity clinics in residential suburbs and the remaining 9 lived in outlying districts or in the provinces from where they were referred. The incidence rate for eclampsia among the 25 stood at .06%. 18 (72%) of the 25 women were nulliparous and 7 (28%) were multiparous. As for the GHU women their ages ranged from 15-32 years with the mean age being 19.7 years. Overall the referred patients were older. 21 (84%) of the GHU patients received antenatal care at least by 34 weeks gestation. The blood pressure of 66.7% of the GHU patients registered normal no pitting edema was evident and no protein was present in the urine 7 days or less before the 1st convulsion. 9 of these 14 were next seen at admission after the convulsion. 3 were normotensive and had no proteinuria. The remaining 2 had only a slight increase in blood pressure (140/90 mmHg) and minimal proteinuria within 4 hours of the 1st convulsion. Incidence increased during the 2nd half of the year. Consistent with earlier research showing an increase of eclampsia when temperature is low and relative humidity high the month of highest incidence August 1982 had a high relative humidity (73%) and was one of the coolest months (16.3 degrees Celsius) in Harare. Eclampsia struck 16 (64%) of the GHU patients before labor 8 (32%) during labor and 1 (4%) after labor. It occurred before labor in all referred cases. The majority of the women had their 1st convulsion after 34 weeks gestation. 10 (40%) patients had their 1st convulsion after being admitted to the hospital yet 30% showed no signs of eclampsia 4 hours before the convulsion.