93 Clin. Exp. Obst. & Gyn. - ISSN: 0390-6663 XLI, n. 1, 2014 doi: 10.12891/ceog15152014 Introduction Antenatal care is defined as the care that a woman receives from healthcare professionals during pregnancy [1]. It is con- sidered an important and effective method for preventing, detecting, and treating high-risk pregnancy by implement- ing maternal education, screening for abnormalities and com- plications, ongoing assessment, and care. In recent years, with the current international immigration patterns, concerns have been raised regarding the care of migrant obstetric pop- ulations. The amount of antenatal care these women receive is variable. This is reflected by the higher mortality and mor- bidity rates among immigrant women compared to non-im- migrant women [2]. There is growing evidence that the risks are further increased among Somali immigrants [3]. The aim of this case report is to document a case of cardiac arrest of a Somali woman in labor due to neglected eclampsia. Materials and Methods A 16-year-old Somali primigravida was seen in the emergency room because of convulsions at 28 weeks gestation. She was pre- viously unregistered in the hospital. She had two convulsive attacks at home prior to coming to the hospital. She suffers from Type I di- abetes mellitus and has been on insulin since childhood. On exam- ination she was having convulsions and her vital signs were: pulse 120/minute, blood pressure 185/120 mm Hg, respiratory rate 30/min, and afebrile. Her convulsions were controlled intravenously with 5 mg of diazepam. Abdominal examination revealed a 28- week single viable breech presentation. Vaginal examination showed a seven cm dilated cervix. The decision was made to per- form an emergency Cesarean section. In the operating room, be- fore commencing the Cesarean section under general anesthesia, cardiac arrest occurred. Resuscitation was then performed. Results Cesarean section was performed during resuscitation. The outcome was 1,000 gram boy with Apgar score of 7, 8, and 10 at one, five, and ten minutes. The maternal condition improved and was transferred to the Intensive Care Unit (ICU) where she was diagnosed to have pulmonary edema and diabetic ketoacidosis which were treated accordingly. She remained in the ICU for four days and was then trans- ferred to the postnatal ward. She was discharged home in good general condition on the 10 th postoperative day. The baby was also well. Discussion Recent publications by Western health providers report peculiar experiences with Somali immigrants. The experi- ence has been that Somali women are often hesitant to ac- cept obstetric interventions, such as induction of labor or Cesarean delivery when indicated [3]. Somali women in the United States have expressed concerns that they fear Cesarean section and that healthcare providers prefer in- terventions, such as Cesarean delivery [4, 5]. There is sub- stantial evidence that language barriers adversely affect access to healthcare, its quality, patient satisfaction, and health outcomes in all hospital services including obstet- rics. Family members or friends are often used as informal interpreters in maternity care settings, although this arrangement can be unethical and potentially-implicated in clinical incidents because of the increased chances in mis- understanding medical words, hospital procedures, and fa- cilities [6]. Therefore, proper translation by bilingual hospital workers is of paramount importance. Antenatal care services should be available for immigrant pregnant Revised manuscript accepted for publication August 16, 2012 Near death of a pregnant Somali woman due to neglected eclampsia A.A. Rouzi, A.M. Almrstani Department of Obstetrics and Gynecology, King Abdulaziz Uinversity, Jeddah (Saudi Arabia) Summary Purpose: To report a case of cardiac arrest of a Somali woman in labor due to neglected eclampsia. Materials and Methods: A 16- year-old Somali primigravida was seen because of convulsions at 28 weeks gestation. She had two attacks of convulsions at home be- fore coming to the hospital. She suffers from diabetes and is insulin-dependent. Her convulsions were controlled with diazepam. Vaginal examination showed a seven cm dilated cervix with high-breech. In the operating room, cardiac arrest occurred. Results: Cesarean sec- tion was performed during resuscitation. The patient’s maternal condition improved and was diagnosed with pulmonary edema and di- abetic ketoacidosis. She was admitted to the intensive care unit (ICU) then transferred to the postnatal ward. She was discharged home and is in good general condition. Conclusion: Inadequate or lack of antenatal care of Somali pregnant women due to many factors, in- cluding ignorance, can result in medical catastrophic situations as illustrated in the current case. Key words: Eclampsia;, Somali woman; Labor.