Progression of pre-eclampsia to eclampsia under spinal anaesthesia


Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, Port Harcourt Rivers State, Nigeria


Eclampsia remains a problem in the developing countries despite improvements in antenatal care and emergency obstetric facilities. It is an important cause of maternal morbidity and mortality in Nigeria. A 26-year-old primipara, residing in an urban city in Nigeria with antenatal care facilities, booked for antenatal care at 36 weeks of gestation and was then diagnosed with severe pre-eclampsia. She initially refused therapy and was later booked for an emergency cesarean section. She had eclamptic fits during cesarean section under spinal anesthesia, and the seizure was aborted with intravenous diazepam. The postoperative period was uneventful. Progression of pre-eclampsia to eclampsia during cesarean section under spinal anesthesia is rare, but it can occur. Early booking for antenatal care to enable an early diagnosis and treatment are necessary to prevent the progression of pre-eclampsia to eclampsia. There is need to educate the populace on the importance of ante natal care so as to improve its utilization.


1. Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol 2009;33:130-7.  Back to cited text no. 1
2. Turner JA. Diagnosis and management of pre-eclampsia: An update. Int J Womens Health 2010;2:327-37.  Back to cited text no. 2
3. Hart E, Coley S. The diagnosis and management of pre-eclampsia. BJA CEPOD Rev Vol 3 Number 2.2003  Back to cited text no. 3
4. Sibai BM. Diagnosis, prevention and management of eclampsia. Obstet Gynecol 2005;105:402-10.  Back to cited text no. 4
5. Agida ET, Adeka BI, Jibril KA. Pregnancy outcomes in eclampsia at the University of Abuja Teaching Hospital. Gwagwalada Abuja: A 3year review. Niger J Clin Pract 2010;13:394-8.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6. Okeudo C, Ojiyi EC, Ezem BU, Dike EI. Preliminary outcome of the management of eclampsia at the Imo State University teaching hospital. Port Harcourt Med J 2011;6:23-9.  Back to cited text no. 6
7. Celik Y, Bekir-Demirel C, Karaka S, Kosa Y. Transient segmental spinal myoclonus due to spinal anaesthesia with bupivacaine. J Postgrad Med 2003;49:286.  Back to cited text no. 7
[PUBMED]  Medknow Journal  
8. Bamgbade OA, Alfa JA, Khalaf WM, Zuokumor AP. Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: A case series. J Med Case Reports 2009;3:7293.  Back to cited text no. 8
9. Abrao J, Bianco MP, Roma W, Krippa JE, Hallak JE. Spinal Myoclonus after Subarachnoid Anaesthesia with Bupivacaine. Rev Bras Anestesiol 2011;61:619-23.  Back to cited text no. 9
10. Sudharma J, Ranasinghe JS, Birnbach D. Current status of obstetric anaesthesia: Improving satisfaction and safety. Indian J Anaesth 2009;53:608-17.  Back to cited text no. 10
11. Visalyaputra S, Rodanant O, Somboonviboon W, Tantivitayatan K, Thienthong S, Saenochote WK. Spinal versus epidural anaesthesia for caesarean delivery in severe pre-eclampsia: A prospective randomized multicenter study. Anesth Analg 2005;101:862-8.  Back to cited text no. 11
12. Santos AC, Birnbach DG. Spinal anesthesia for caesarean delivery in severely preeclamptic women: Don't throw out the baby with the birth water! Anesth Analg 2005;101:859-61.  Back to cited text no. 12
13. The Magpie Trial Collaborative Group. Do women with pre-eclampsia and their babies benefit from magnesium sulphate? The Magpie Trial: A randomized placebo-controlled trial. Lancet 2002;359:1877-90.  Back to cited text no. 13