OBJECTIVE We sought to identify trends, demographics, and pre-pregnancy and peripartum morbidities of eclampsia in California. STUDY DESIGN We identified cases of eclampsia by International Classification of Diseases, Ninth Revision code using California health discharge data from 2001 through 2007. Cases with missing race/ethnicity as well as age <15 years or >55 years were excluded. Among the remaining cases, patients with eclampsia (n = 1888) were compared against those without (n = 2,768,983). Adjustments were performed for potential confounding variables using logistic regression. Significance was set at P < .05. RESULTS The incidence of eclampsia decreased over time, from 8.0 cases per 10,000 deliveries in 2001, to 5.6 cases per 10,000 deliveries in 2007 (P < .001). There was a bimodal distribution in age-related risk, with the highest risks at the extremes of age. Non-Hispanic blacks were associated with the highest risk of eclampsia while Asians had the lowest risk. Several antepartum morbidities had increased associations with eclampsia, including preexisting cardiac disease (adjusted odds ratio [OR], 6.84; 95% confidence interval [CI], 5.40–8.66), lupus erythematosus (adjusted OR, 3.68; 95% CI, 1.53–8.86), and twin gestations (adjusted OR, 3.28; 95% CI, 2.70–3.99). Peripartum complications increased in eclampsia included cerebrovascular hemorrhage/disorders (adjusted OR, 112.15; 95% CI, 77.47–162.35), peripartum cardiomyopathy (adjusted OR, 12.88; 95% CI, 6.08–27.25), amniotic fluid embolism (adjusted OR, 11.94; 95% CI, 3.63–39.21), and venous thromboembolism (adjusted OR, 10.71; 95% CI, 5.14–22.32). CONCLUSION This large population database confirms that there is a decline in eclampsia over time. However, there are extremely morbid complications associated with eclampsia, emphasizing the need for its close monitoring and prevention.

MS is a rare condition which is more likely to affect older Caucasian women of higher socioeconomic status and is associated with several preexisting medical conditions. MS, however, does not appear to pose significant increases in adverse pregnancy outcome. This suggests that pregnant patients with MS may likely experience an uneventful pregnancy.

Several antepartum and peripartum conditions and procedures are associated with significantly higher risks of amniotic fluid embolism. This information may contribute to a better understanding of the pathophysiology of AFE and potentially help identify those at the highest risk of developing this morbid condition.

Objective The aim of this study was to compare duration of labor induction between diabetic and nondiabetic women receiving dinoprostone vaginal insert (10 mg). Study Design This is a secondary analysis of two large randomized controlled trials using dinoprostone vaginal inserts for labor induction. We compare time to active labor, overall delivery, and vaginal delivery between diabetic and nondiabetic women undergoing induction of labor with a 10-mg dinoprostone vaginal insert. Results Diabetic women receiving dinoprostone vaginal insert had a longer time to onset of active labor, overall delivery, and vaginal delivery than their nondiabetic counterparts. There was no difference in abnormal labor affecting fetal heart rate pattern in diabetic women compared with nondiabetic women. The rates of neonatal hyperbilirubinemia were higher in diabetic women. Conclusion Diabetes may represent an independent factor associated with prolonged induction among women undergoing induction of labor with dinoprostone. Dinoprostone is well tolerated in both diabetic and nondiabetic women. Key Points

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