Eclampsia : Causes, Symptoms And Treatment

Eclampsia is the onset of convulsion (seizure) in a pregnant woman or recently delivered woman with preeclampsia (high blood pressure related to pregnancy). It is one of the causes of death in pregnant women. It is a medical emergency. Eclampsia means seizures in pregnancy/postpartum that are not explained by another cause (like epilepsy or meningitis).

Eclampsia is the commonest cause of convulsion in pregnancy. It affects pregnant women in low income countries. Though eclampsia can occur in developed countries, It is common in countries with poor health care system. Poor treatment of preeclampsia will also cause eclampsia.

What is preeclampsia?

This is the presence of blood pressure ≥ 140/90 in pregnancy (usually after 20 weeks) with protein in urine or other signs that organs are affected.

There are many risk factors that predispose to preeclampsia in pregnancy. This has been outlined in this article.

Preeclampsia : Definition, Causes, Symptoms, Signs And Risk Factors.

However, Not all pregnant women with high blood pressure will develop convulsion. Convulsion in eclampsia is short lived and may stop on its own, but it can recur and can be dangerous.

Therefore, quick treatment is necessary for all patients with eclampsia. This is because eclampsia can cause death to the mother and baby.

Antenatal clinic is your first contact with your doctor. Your blood pressure is checked and routine blood test is done. Your blood pressure is monitored throughout your clinic visits.

Severe preeclampsia is the presence of high blood pressure of 160 mmHg (top number) or 110 mmHg (bottom number) and above. Preeclampsia symptoms include the following.

• Presence of frontal headache that is persistent

• blurring of vision or visual disturbances

• right upper abdomen pain

• Upper abdomen pain or epigastric pain

• vomiting and nausea

Pregnant women with preeclampsia require treatment. This helps to prevent onset of eclampsia. Eclampsia is more common in pregnant women who did not attend antenatal care. If you are pregnant, it is necessary to see your doctor.

What Are The Risk Factor Of Eclampsia

The common risk factors that predispose to eclampsia are

• First time moms

• Multiple pregnancies

• High body mass index

• Preexisting conditions like hypertension

• Family history of eclampsia is a risk factor

• Poor equipped health centers

What Causes Convulsion In pregnancy

The most common cause of convulsion in pregnancy is eclampsia. But this does not rule out other causes.

Other common causes of convulsion in pregnancy are

• Epilepsy. But they do not have high blood pressure and protein in urine

• Meningitis. However, patients develop stiff neck and high body temperature.

Other causes of convulsion in pregnancy include

• Encephalitis

• cerebral malaria is common in developing countries. There is no high blood pressure or protein in urine

• HIV and AIDS

• Diabetic coma in pregnancy

What Causes Eclampsia In Pregnancy

The cause of eclampsia is still unknown. However, it is due to problems with the placenta and blood vessels in vital organs. Some of theses organs include the brain, heart, lungs and liver.

If it affects the brain, it will cause cerebral edema.

What Are Eclampsia Symptoms And Signs

• Frontal headache

• Blurring of vision

• Upper abdominal pain

• Vomiting

• Convulsion

• Edema of the hands, feet and face

• Coma

Blood pressure is usually atleast 140/90mmHg. There is often protein in urine, but it is not always present.

What Test Can Be Done In Eclampsia?

Basic test done for eclampsia include

• Urinalysis- Your urine is checked for protein. Some hospitals use a spot protein/creatinine test instead of collecting urine for 24 hours. Urine dipstick test is an alternative screening test.

• Blood pressure- high blood pressure in pregnancy is a problem. Blood pressure ≥140/90 is abnormal.

• Complete blood count- This is important to examine blood cell indices. This include your red blood cell, white blood cell and platelet levels. Platelets help in blood clotting. They can be deficient in patients with complicated eclampsia. This can result to bleeding.

• Abdominal scan- This is important to evaluate the baby’s clinical condition. The age of the baby is also assessed. This important to for best treatment. Furthermore, other vital organs like the liver and kidneys are also evaluated.

What Is The Treatment Of Eclampsia

The cure for eclampsia is delivery of the baby and placenta. This is same with preeclampsia.

You can read the complete guide to preeclampsia diagnosis and treatment.

Poor treatment of preeclampsia is a danger sign for eclampsia. Most pregnant women with eclampsia are unconscious or in coma.

Your doctor will quickly ensure the airways are patent. Mucus is suctioned from the mouth and nostril. Next, your doctor will ensure breathing and blood flow. This is by checking your pulse.

Pregnant women with convulsion should be treated with care. It should be aborted quickly. Convulsion in eclampsia is shortlived and self limiting.

Left lateral position is the best choice. This is to prevent the baby’s weight from affecting blood flow.

Quick delivery is the ultimate goal for eclampsia treatment, after the mother is stabilized (stop further fits, control blood pressure, protect breathing).

There are 3 goals to eclampsia treatment.

• To control convulsion in the fastest way

• The control of high blood pressure

• To deliver the baby by the safest route.

How Is Convulsion Treated In Eclampsia

Convulsion in common in eclamptic women. Quick treatment of convulsion is therefore important. The drug of choice is magnesium sulphate. It helps to prevent recurrent seizure. It is the best anti seizure drug used in eclampsia treatment.

However, magnesium sulphate is toxic at high doses. It requires close monitoring. Your doctor will monitor your breathing rate and reflexes. Slow breathing, absent/weak reflexes, or very low urine output are danger signs.

But there is good news too. High toxic levels of magnesium sulphate is treated with calcium gluconate.

How To Treat High Blood Pressure In Eclampsia

The drug of choice for high blood pressure treatment is hydralazine and labetalol (and sometimes nifedipine).

High blood pressure is treated with Hydralazine. It acts on blood vessels to dilate them. This helps bring blood pressure down and protects vital organs. However, hydralazine has its side effects. These include awareness of heartbeat, restlessness, headache.

Labetalol is safe in pregnancy. It lowers blood pressure in pregnant eclamptic women. Your doctor decides the best drug and dose for you and the baby.

How To Deliver Your Baby In Eclampsia

Many pregnant women with eclampsia can deliver vaginally, but cesarean section may be needed depending on the situation.

The choice of delivery depends on these factors

• The risk to the mothers health

• If the baby is in distress

• The age of the pregnancy

If you are near term, labor may be induced. Induction of labor is ripening the cervix to start labor. However, if your baby is preterm (often below 34 weeks), you may need steroids. This is to help your baby’s immature lungs. Also, prolonged labor may require forceps delivery.

The need for quick intervention might require urgent action. This maybe due to fetal distress and risk to the mother. The use of cesarean section is an option.

What Are Eclampsia Complications

• Kidney failure.

• heart failure

• High body temperature

• Bleeding

• Stroke

• Premature babies

• HELLP syndrome– this comprises of haemolysis, elevated liver enzymes and low platelets

• Death to mother and baby

Let us know if you have high blood pressure in pregnancy. Are u a doctor? lets share your experiences.

Thank you.