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We observed a case of eclampsia suddenly occurring at 22 weeks’ gestation, which progressed to placental abruption and intrauterine fetal death. At 22 weeks’ gestation, the patient’s blood pressure increased, and she had convulsions and lost consciousness. The patient was transferred to the tertiary center and a course of observation was chosen due to the prematurity of the fetus. However, 2 days after onset of eclampsia, the patient experienced acute abdominal pain, and retro-placental hematoma and fetal death were confirmed on ultrasonography. In addition, findings typical of posterior reversible encephalopathy syndrome were demonstrated on MRI. Although labor was induced, the patient’s condition worsened and emergency cesarean section was performed. After the operation, the patient’s clinical course was good and she was discharged without any complications. Eclampsia onset at such an early gestational age is quite rare. We must be cognizant that the outcome of the disease may be poor.

A case of very early onset eclampsia, placental abruption and intrauterine fetal death