During the period of our study, we recorded 76 cases of postpartum eclampsia out of a total of 8714 admissions, i.e. a frequency of 0.87%. The average age of our patients was 23, with extremes of 15 and 39; the 20 - 24 age group accounted for 33%. Housewives were found in 70% of cases ( Table 1 ).

Among the reasons for admission, loss of consciousness accounted for 24%, hypertension 21% and seizures 55%. The average time to onset of seizures in the post-partum period was 3.8 days, with extremes of 1 and 30 days. Patients who convulsed on the first postpartum day accounted for 45%, between days 2 and 7 for 22.5%, between days 8 and 14 for 23.5%, between days 15 and 21 for 6.5% and between days 21 and 30 for 2.5%. The average number of seizures was 4.1, with extremes of 2 and 12. More than half (58%) had more than three seizures. Predictive signs of eclampsia were headache (30.3%) and visual disturbances (19.69%). In terms of general signs, 43.5% of patients were in poor general condition, with systolic blood pressure over 160 mmhg in more than half the cases. Predictive signs of eclampsia and general signs are shown in Table 2 and Table 3 respectively.

Urea and creatinine levels were taken in all patients. Three cases of renal failure were diagnosed, i.e. 4%, with creatinine levels above 90 µmol. Albuminuria was greater than or equal to 4 crosses in 92% of cases, with extremes of 2 and 4 crosses. Liver function tests were carried out in 40 patients (52.5%). Elevated liver enzymes were found in 5 patients (12.5%). Obstetrical ultrasound was performed in all 76 patients, and revealed placental debris in 21 (27.63%). Electrocardiograms were performed on 7 patients during hospitalization, i.e. 9.2%, with 3 cases showing no particularities and 4 cases showing abnormalities such as sinus bradycardia, right bundle branch block, subepicardial ischemia and anteroseptal ischemia respectively. Fundus examinations were performed in 6 patients (8%), with 3 patients showing abnormalities such as bilateral partial retinal detachment, hypertensive retinopathy and vitreous haemorrhage, and 3 patients with no abnormal fundus findings.

In our study, 32 patients presented complications attributable to eclampsia, i.e. 42.10% of our sample. Among these complications, 3 cases of acute lung edema were reported; 13 patients (17%) were anemic, 3 cases (4%) of renal failure, 5 cases (6.57%) of Hellp syndrome, 5 cases (6.57%) of cardiac abnormalities on electrocardiogram and 3 cases (4%) of fundus abnormalities such as bilateral partial retinal detachment, hypertensive retinopathy and vitreous hemorrhage. We recorded 4 cases of maternal death, for a case-fatality rate of 5.2%.

Post-partum eclampsia remains a fairly frequent pathology in our context; we found a frequency of 0.87% in relation to admissions to the obstetrics department. This rate is similar to those reported by Belley in Douala and Chhabbra [16] in India, who reported 0.95% and 0.98% respectively in their series. It is higher than those of Lubarsky in the USA [17] , Ducarme in France [18] ; Bourret in Rouen [19] , who reported respective rates of 0.29%, 0.81‰ and 0.35‰ of postpartum eclampsia in their studies. Analyzing these results we note a great variability in the frequency of postpartum eclampsia across countries and even regions of the globe. In fact, in developed countries, thanks to better organization of prenatal surveillance and improved patient care, the incidence of this condition is low. In developing countries, on the other hand, the high incidence may be linked to inadequate health coverage and poor management of hypertensive states associated with pregnancy. Several studies report a higher incidence of postpartum eclampsia in younger patients [16] [20] . Similarly, a study in Uganda found that postpartum eclampsia was more common in patients under 24 years of age [21] . This confirms our results, where the average age of our patients was 23, with 33% under 24. Regarding origin, the majority of patients in our series came from rural areas, with a proportion of 72%. This is indicative of the urgency of eclampsia and the difficulty of managing it in peripheral health centers, due to limited technical resources. In our study, housewives were in the majority (70%). This vulnerability may be linked to the physical and psychological overwork to which they are exposed, and which predisposes them to severe pre-eclampsia that can complicate into eclampsia in the postpartum period if not treated properly.

The clinical picture of eclampsia includes seizures superimposed on existing symptoms of pre-eclampsia. In our study, seizures were noted as the reason for admission in 55.26% of cases. The vast majority of seizures usually occur within the first 48 hours postpartum [22] . We reported 45% of cases occurring in the immediate postpartum period. This should not obscure the possibility of eclampsia occurring several weeks after delivery, as reported by Minnerup et al [23] in Germany, with postpartum eclampsia occurring 8 weeks after delivery. Headache, visual disturbances, epigastric pain and sharp osteotendinous reflexes are the only clinical signs predictive of eclampsia. At least one of these is found in 85% of cases [24] . Patients with delayed eclampsia report the occurrence of these predictive signs in the hours preceding the attack, and admit not having consulted a doctor [25] . They attribute these symptoms to postnatal fatigue. We noted respectively 30% of headaches and 19.69% of visual disturbances. Eclampsia is accompanied by a disturbance in the state of consciousness, progressively ranging from a dazed state to coma. In our series, 10.53% of patients were in coma. This can be explained in part by the rapid evolution of the pathology, but also by the delay in consultation and accessibility of health and care centers.

In our series, we noted 31.6% of maternal complications attributable to eclampsia. Conde-agudelo [26] in Colombia found 30% maternal complications, similar to our rate. Postpartum eclampsia is a life-threatening obstetric emergency. Properly managed, the outcome can be favorable, but death can also occur in cases of delayed consultation and poor management including failure to comply with the magnesium sulfate and catapressan protocol, and inadequate vascular filling. The case fatality rate for postpartum eclampsia in our study was 5.2%. Lubarsky [17] in the USA and Sibai [27] in England found no eclampsia-related maternal deaths in their studies. The deaths observed in our study were related to a delay in consultation, and these patients were admitted in a comatose state.

The retrospective nature of our study was a source of limitations, notably the lack of information in certain files, and the state of consciousness of certain patients at entry. Despite these limitations, we arrived at these results, which we have compared with data in the literature.