Eclampsia

Conditions 26.04.2019

Eclampsia is characterised by induced high blood pressure with seizures unrelated to epilepsy or other brain disorders or conditions. It is unique to pregnancy.

The word eclampsia comes from the Greek word "eklampsis" = "a shining forth" / "bolt from the blue"
Eclampsia is characterised by induced high blood pressure with seizures unrelated to epilepsy or other brain disorders or conditions. It is unique to pregnancy.
Eclampsia may be the final and most severe phase of pre-eclampsia, or it can occur without pre-eclampsia symptoms.
Eclampsia can occur before (antepartum,) during (intrapartum) or up to 48 hours after delivery of the baby (postpartum).
Eclampsia is dangerous and must be treated immediately to avoid potentially dangerous complications.

The cause of eclampsia cannot really be explained.
Factors that could increase a woman's risk of getting eclampsia:
- undetected high blood pressure (chronic or gestational)
- pre-eclampsia left untreated,
- pre-eclampsia never detected and
- severe cases of pre-eclampsia (Although eclampsia is more likely to occur in severe cases of pre-eclampsia, it can also occur in mild cases)
There is not a definite way to predict which women with pre-eclampsia will get eclampsia

Eclampsia is characterised by convulsions (seizures/fits) and disseminated intravascular coagulation (DIC) which affects the liver, kidneys, brain, heart and placenta.
Other symptoms:
- severe headaches
- hyperreflexia - overactive or over-responsive reflexes.
- severe agitation
- unconsciousness
- muscle aches and pain
- blind or partially blind areas in the field of vision. White spots are sometimes evident during the aura of a migraine headache.

High blood pressure and the presence of seizures or coma are the only symptoms required for diagnosis.
Any pregnant woman with high blood pressure who has a seizure that can't be attributed to some other cause can be diagnosed with eclampsia.

A woman with eclampsia is usually in hospital when seizures occur and if she is not, due to the nature of the sudden onset of the condition, unforeseen or socio-economical circumstances or a home birth, she should get to hospital as soon as possible.
Delivery of the baby and placenta is usually the treatment of choice for eclampsia in a pregnancy over 28 weeks. For pregnancies less than 24 weeks, the start of labour is recommended, although the baby may not survive.
Magnesium sulphate might be given to prevent and s top seizures when they are occurring. It is an anticonvulsant drug and is safe for both the mother and the baby.

If pregnancy is prolonged and eclampsia is left untreated, it can result in the death of mother and baby.
Eclampsia can cause the mother to go into a coma and can cause brain damage.
It can lead to postpartum health issues, such as chronic high blood pressure and liver or kidney problems.
During a seizure, mother and baby are at risk of being deprived of oxygen.
In addition, the high blood pressure may cause the placenta to begin to separate from the wall of the uterus, called a placenta abruptio.
The above-mentioned outcome is rare and most women make a full recovery from eclampsia

There is no known prevention of eclampsia.
Some measures can be taken to ensure early detection of pregnancy-induced high blood pressure/increased chronic high blood pressure / gestational hypertension and pre-eclampsia:
- Start with your antenatal visits to your doctor as soon as you can in your pregnancy.
- Never miss an appointment.
- Make sure you are monitored more frequently if your blood pressure is raised.
- Always report any worrying signs or symptoms to your doctor and do not allow him or her to dismiss you without first checking your blood pressure and urine.