Study protocol: Effect of inulin supplementation on gut microbiota in patients with oral lichen planus - A double-blind, randomised, placebo-controlled parallel-group trial.

Hypertensive disorders of pregnancy (HDP) remain among the leading causes of maternal and perinatal morbidity and mortality worldwide. Eclampsia is a severe obstetric complication defined by the occurrence of new-onset seizures in women with hypertensive disorders of pregnancy, in the absence of preexisting neurological conditions such as epilepsy or cerebrovascular disease. Although eclampsia may occur antepartum or intrapartum, it most frequently manifests within the first 48 h postpartum, typically after 20 weeks of gestation. The Global Burden of Disease data show a decline in the overall burden of HDP but lack specific estimates for eclampsia. The incidence of eclampsia varies from 2 to 10 per 10,000 deliveries in high-income countries (HICs) and 50 to 151 per 10,000 deliveries in low- and middle-income countries (LMICs). These disparities are largely attributed to differences in access to antenatal care, early detection, and management of preeclampsia, as well as variations in study design and case identification methods. Clinical evidence indicates that approximately 42% of women are diagnosed with preeclampsia prior to seizure onset, while one-third experience their first seizure during the postpartum period. Hypertension is the most commonly reported clinical sign, present in over 90% of cases. Eclampsia is associated with severe maternal complications, including HELLP syndrome, disseminated intravascular coagulation, acute kidney injury, pulmonary edema, and cerebrovascular events, with cerebrovascular complications alone accounting for up to 70% of deaths among women with hypertensive disorders of pregnancy. Clinical and obstetric predictors of preeclampsia and eclampsia including high body mass index, nulliparity, chronic hypertension, gestational diabetes, renal or cardiac disease, infections, severe anemia, and inadequate antenatal care utilization.