Eclampsia

What is Eclampsia ?

Definition : Eclampsia is a condition characterized by life threatening seizures in a pregnant woman who already has preeclampsia [1]. Eclampsia causes seizures and coma in a pregnant woman who does not have any preexisting or organic disorders concerning the brain [2].

About 1 out of every 2000 – 3000 pregnancies is affected by eclampsia [3].

Eclampsia preeclampsia image photo picture

Preeclampsia and eclampsia are collectively referred to as hypertensive disorder of pregnancy and toxemia of pregnancy [4]. They are so termed because both these conditions occur due to high blood pressure in pregnant women.

Causes of eclampsia

The exact cause of eclampsia is not clearly defined. However, there are various factors that have been thought to play a role in development of eclampsia in pregnant women. These include [1, 2]

  • Preeclampsia – If the mother has preeclampsia then the chances of the child developing eclampsia increases to a great extent.
  • Obesity – Obese women are at a higher risk of developing eclampsia as compared to normal weight women.
    Problem with the blood vessels
  • Genes – Genes have been shown to play a pivotal role in causation of eclampsia.
  • Diet – Pregnant women having diet deficient in vitamin are at more risk of developing elcampsia.
  • Irritability of the brain and central nervous system

Symptoms of eclampsia

Eclampsia is marked by occurrence of tonic – clonic seizures in pregnant women [5]. The signs and symptoms of eclampsia are similar to those of preeclampsia, but may vary at times depending on the organs affected [1]. Before the onset of the eclamptic event, the patients may exhibit

Signs and symptoms of hypertension and proteinuria.

  • Abdominal pain
  • Headaches
  • Cortical blindness
  • Oliguria
  • Nausea and
  • Vomiting

The eclamptic event occurs in 4 different stages [2, 4]:

  1. Stage 1 – is marked by occurrence of invasion facial twitching that occurs around the mouth region.
  2. Stage 2 – is defined as the tonic contractions also known as tetanic contractions. This stage is characterized by sustained muscular contractions that last for about 15 – 20 seconds. In this women may experience muscle aches and pains.
  3. Stage 3 – This is the stage of convulsion characterized by involuntary and forceful muscular contractions that lasts for about 1 minute. In this stage, the patient’s tongue can get bitten involuntarily and foam appears over the mouth. The patient is unable to breathe and turns cyanotic.
  4. Stage 4 – This is the final state, wherein the patient reaches the comatose stage. When the patient recovers from coma, she is less likely to recollect and remember anything that had just happened. She is also likely to get agitated and combative when she recovers from coma [6]. Some patients in this state may also experience temporary blindness after they recover from coma.

In certain cases, it may so happen that pregnant women may directly fall into coma without the occurrence of seizures.

When to seek medical care

Pregnant women are advised to contact the medical professional whenever they first observe the initial signs and symptoms of eclampsia.

You also need to call up the emergency department if you experience the following warning signs –

  • If your blood pressure measure 160 / 110 mm Hg or more
  • Sudden and excessive swelling in the face and hands
  • Seizures
  • Decreased alertness
  • Bright red vaginal bleeding’
  • Severe headache
  • Your baby moves very little or does not move at all
  • Loss of vision
  • Nausea and vomiting
  • Severe pain in the upper abdominal area

Eclampsia diagnosis

Eclampsia usually follows preeclampsia. Therefore, if you already have preeclampsia, then preeclampsia – related tests as well as other tests will be done to confirm eclampsia. These tests include [3, 7]

Blood tests – To determine

  • Hematocrit
  • Platelets count
  • Level of creatinine (increased levels in blood indicate that the kidneys are unable to filter off creatinine from blood).
  • Liver functioning
  • Blood clotting factors

Urine tests – to determine

  • Presence and level of protein
  • Presence of uric acid

Treatment of eclampsia

There are 2 treatment modes available for treating eclampsia – each aimed at saving the life of both the mother and her baby. The treatment modes consist of:

Drugs and Medications

Certain medications such as antihypertensive drugs and anticonvulsants are prescribed for lowering the blood pressure and also to prevent seizures. Magnesium sulfate is considered to be safe for both the mother and baby and hence is administered to the pregnant woman for preventing seizures.

This drug is primarily given to pregnant women with preeclampsia in order to prevent eclampsia from occurring. Dilantin has also been used for treating eclampsia; however it is not as effective as magnesium sulfate.

Once the condition of the mother is stable and under control, the doctors prefer for delivery of the baby [8].

Delivery of the baby

If the blood pressure is still on the higher side and the baby is in a distressed state, delivery of the baby should be carried out at the earliest. In order to prevent complications in the baby and mother, it is best that delivery is done and further complications are avoided [3].

Steroid drugs may be given to the mother, if the baby’s lungs have not matured enough and emergency delivery needs to be carried out [9].

Eclampsia follow – up

It needs to be very well understood that there are no tests to predict the occurrence of eclampsia in the future. However, the chances of recurrence of eclampsia increase if women have suffered from preeclampsia and or eclampsia in their early stages of pregnancy.

Due to absence of tests to predict occurrence of eclampsia, it is therefore recommended that the affected women be closely monitored during their post – partum visits and also during their next pregnancies [10].

Eclampsia prognosis

It has been reported that majority of the women with eclampsia will have good pregnancy outcome [11]. It has also been estimated that about 25% of women will continue to have elevated blood pressure for their next pregnancies and about 2% will again suffer from attacks of eclampsia.

Babies born to women with eclampsia will usually do well and those babies who were prematurely delivered will require a longer stay in the hospital for close monitoring.

References:

  1. http://www.emedicinehealth.com/eclampsia/article_em.htm
  2. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001901/
  3. http://www.nlm.nih.gov/medlineplus/ency/article/000899.htm
  4. http://en.wikipedia.org/wiki/Eclampsia
  5. http://www.news-medical.net/health/What-is-Eclampsia.aspx
  6. http://emedicine.medscape.com/article/253960-overview
  7. http://www.healthline.com/health/eclampsia
  8. http://www.emedicinehealth.com/eclampsia/page5_em.htm#eclampsia_treatment
  9. http://www.patient.co.uk/health/pre-eclampsia
  10. http://www.emedicinehealth.com/eclampsia/page7_em.htm
  11. http://www.emedicinehealth.com/eclampsia/page8_em.htm

Published on January 17th, 2018 by under Pregnancy.
Article was last reviewed on January 24th, 2018.

Leave a Reply

Back to Top