Hastie R, Brownfoot FC, Cluver CA, et al. - Researchers investigated the predictive value of signs and symptoms that occur before the onset of eclampsia among pregnant women via performing a systematic review. Searching electronic databases, including MEDLINE, EMBASE, Cochrane, and ClinicalTrials.gov from inception to 2018, they retrieved 2,791 records; of these, 11 were selected. Studies were significantly heterogeneous, with differing designs, settings, participants, and signs or symptoms. They observed reporting of 28 signs or symptoms; visual disturbances and epigastric pain were most common (six studies), followed by headache (five studies), and any edema (four studies). None of the pooled estimates led to accurate prediction of eclampsia nor ruled out eclampsia in their absence, with moderate specificity (83–94%) and poor sensitivity (29–56%). It seemed inapt to provide pooled estimates for the majority of signs and symptoms as meta-analyses generally require more than two studies.