Objective: In Morocco, eclampsia remains the second major cause of maternal mortality. Conventionally, patients with preeclampsia and neurosensory signs (NSS) (e.g., headaches and hyperreflexia) are considered at high risk of worsening and progressing to eclampsia. However, this specific population is heterogeneous in terms of eclampsia occurrence. We aimed to identify the risk factors for the development of eclampsia in women with preeclampsia presenting with NSS at admission. Materials and Methods: We performed a single-center, retrospective case-control study of patients with preeclampsia with positive NSS from January 1st, 2012 through December 31st, 2015, to investigate predictive factors for eclamptic seizures The case patients were pregnant women with severe preeclampsia who had NSS before developing eclampsia. Control subjects were those with positive NSS without the development of seizures during their hospital stay. One hundred-thirty eight patients with eclampsia and 272 control patients were enrolled. Results: Univariate analysis revealed that eclampsia was more likely to develop in patients with the following risk factors: maternal age <= 25 years (chi(2)=9.58, p=0.002), primiparity (chi(2)=6.38, p=0.011), inadequate prenatal care (chi(2)=11.62, p=0.001), systolic hypertension >= 160 mmHg (chi(2)=15.31, p= 110 mmHg (chi(2)=5.7, p=0.017), generalized acute edema (chi(2)=14.66, p<0.001), hematocrit 100 mu mon. (chi(2)=13.46, p70 IU/L (chi(2)=10.15, p=0.001), and thrombocytopenia (chi(2)=22.73, p<0.001). Additionally, independent predictive factors for eclampsia in multivariate analysis included inadequate prenatal care [odds ratio (OR), 8.96 [95% confidence interval (CI): 3.9-20.5], p= 160 mmHg (OR, 3.130 [95% CI: 1.342-7.305], p=0.008), thrombocytopenia with a platelet count = 70 IU (OR, 3.575 [95% CI: 1.313-9.736], p=0.007), and elevated liver enzymes level, and low platelet count (ELLP) syndrome, which is an incomplete variant of (HELLP) syndrome (H for hemolysis) (OR, 5.83 [95% CI: 2.43-13.9], p<0.001). Conclusion: This work highlights two major risk factors in this patient population, inadequate prenatal care and ELLP syndrome, which can help in the early identification of patients at highest risk of developing eclampsia and guide preventive measures.

Difficulties have risen while managing Acute Respiratory Distress Syndrome (ARDS) caused by COVID‐19, although it meets the Berlin definition. Severe hypoxemia with near‐normal compliance was noted along with coagulopathy. Understanding the precise pathophysiology of this atypical ARDS will assist researchers and physicians in improving their therapeutic approach. Previous work is limited to postmortem studies, while our report addresses patients under protective lung mechanical ventilation. An open‐lung minithoracotomy was performed in 3 patients who developed ARDS related to COVID‐19 and were admitted to the intensive care unit to carry out a pathological and microbiological analysis on lung tissue biopsy. Diffused alveolar damage with hyaline membranes was found, as well as plurifocal fibrin microthrombi and vascular congestion in all patients’ specimens. Microbiological cultures were negative, whereas qualitative Reversed Transcriptase Polymerase Chain Reaction (RT‐PCR) detected SARS‐CoV‐2 in the pulmonary parenchyma and pleural fluid in two patients. COVID‐19 causes progressive ARDS with onset of severe hypoxemia, underlying a dual mechanism: shunt effect through diffused alveolar damage and dead space effect through thrombotic injuries in microvascular beds. It seems reasonable to manage this ventilation‐perfusion ratio mismatch using a high dose of anticoagulant combined with glucocorticoids.