Eclampsia at 20 Weeks of Gestation
A 23-year-old primigravida with an unknown last menstrual period and 20 weeks gestation by ultrasound presented with a history of headache, fever, vomiting, and new-onset of convulsions. At the time of her admission, the full blood count instrument at our hospital was out of service. A rapid blood test for malaria was positive. After an initial blood pressure of 164/127 and 3+ proteinuria on a urinary dipstick, the diagnosis of eclampsia was made. She was given magnesium sulfate by intravenous protocol and labor was induced with vaginal misoprostol. She delivered a nonviable premature infant after six hours. This case presentation is remarkable for the early gestational age of 20 weeks at which the convulsions occurred. 91% of all cases of eclampsia develop at or after 28 weeks gestation. 7.5% occur between 21 and 28 weeks. Only 1.5% occurs at 20 weeks or earlier.

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