Evaluation of Seizure Disorders in Eclamptic and Pre-Eclamptic Patients: A Prospective Analysis from a Tertiary Care Hospital

Abstract

Objective:  To evaluate the types, frequency, and clinical presentations of seizures in patients with eclampsia and preeclampsia, assess neuroimaging findings, including the prevalence of Posterior Reversible Encephalopathy Syndrome (PRES) and other cerebral abnormalities, and analyze maternal and fetal outcomes in relation to seizure characteristics and treatment strategies.

Materials & Methods:  This prospective observational study was conducted at the Department of Obstetrics and Gynecology in collaboration with Neurology at Lady Reading Hospital, Peshawar, from January 2024 to June 2025. A total of 134 patients with eclampsia or severe preeclampsia presenting with seizures were enrolled. Clinical data, seizure type, imaging findings, treatment details, and maternal fetal outcomes were documented. The chi-square and logistic regression tests were applied for outcome associations’ assessments.

Results:  Of the 134 patients 70.1 percent had eclampsia and 29.9 percent had preeclampsia with seizures Generalized tonic clonic seizures were observed in 88.8 percent focal seizures in 8.2 percent and status epilepticus in 3 percent Neuroimaging was performed in 63.4 percent of patients revealing PRES in 36.5 percent Magnesium sulfate was administered in 96.3 percent ICU admission was required in 24.6 percent and maternal mortality was 3.7 percent Intrauterine fetal demise occurred in 13.4 percent and NICU admission was needed in 16.4 percent of neonates.

Conclusion:  Seizures in hypertensive pregnancies are predominantly generalized and associated with PRES Early clinical and imaging assessment with prompt magnesium sulfate administration is essential to improve maternal and fetal outcomes.