Pregnancy Eclampsia

What is Eclampsia?

Eclampsia is one of the life-threatening complications of pregnancy.  It can happen during pregnancy or as a postpartum eclampsia. Eclampsia the most severe classification of Pregnancy Induced Hypertension (PIH).  There is the presence of convulsions or seizures but is not related to any brain conditions.  A pregnant woman who previously had preeclampsia can develop seizures or sometimes coma.  The term toxemia is usually referred to preeclampsia and eclampsia.

The eclampsia pathophysiology starts from vascular spasm having vascular, kidney and interstitial effects.  With the vascular system, there is vasoconstriction resulting to poor organ perfusion thereby increasing the blood pressure.

The vasospasm in the kidney increases resistance in blood flow.  Filtration rate is decreased.  This will result to increased serum-blood urea nitrogen (BUN), uric acid, and creatinine.  This explains the decreased urine output and protein in the urine or proteinuria.  Diffusion of fluid from blood stream into interstitial tissue results into edema or swelling.

What are the causes of Eclampsia?

Preeclampsia or eclampsia causes are unknown. There are no effective tests or eclampsia diagnosis tools to detect earlier if eclampsia will occur, neither do eclampsia treatment for prevention is available as of the moment.  However, for some unknown reasons, African American women are at a greater risk in developing eclampsia than white women.  Eclampsia prevention is useless, since the cause of this disorder is unknown.  It will not be of any help thinking about the factors that could have contributed to its development.  However, prenatal care and early management can lessen the risk of suffering complications.

Age is also a factor that can increase the risk of having eclampsia.  Pregnancy at 40 years or older have been found to increase the frequency of the disease.  However, younger women have been found to be also at risk.

What are the symptoms of Eclampsia?

Eclampsia’s hallmark is the seizure.  It can either affect only the mother or the baby, or both.  Here are some of the symptoms.

· High blood pressure.  Elevated blood pressure can be different from woman to woman.  However, it is believed that a blood pressure of 160/110 mm Hg or above is at risk of eclampsia.

· Increased protein in the urine.  The kidneys cannot filter the blood and can also lead to decreased urine output.

· Blurring of vision, severe headache, convulsions, and occasional blindness.

· Decreased fetal movements.

When to seek medical attention?

· Persistent or sever headaches or any disturbances in vision needs medical attention.

· When your blood pressure is 160/110 mm Hg or above.

· Pain in the belly or under the right side of your ribs.

· Unusual bruising or bleeding.

· Weight gain due to excessive swelling.

· Decreased fetal movements.

· Vaginal bleeding.

Complications of Eclampsia

Eclampsia complications can result to fetal prognosis is poor due to hypoxia and fetal acidosis.  When premature placental separation or abruptio placenta from vasospasm occurs, the chances that the fetus will survive is much lesser.  If the fetus needs to be delivered before term, risks related to immaturity will be dealt with.  Maternal mortality is as high due to cerebral hemorrhage, circulatory collapse, or kidney failure.

Postpartum eclampsia is likely to occur.  Patients may need antihypertensive therapy after giving birth and upon discharge.  A follow up is needed to monitor the blood pressure and control any deficits from the eclamptic seizure.  This disease is managed on an inpatient basis.