Eclampsia

Definition

Eclampsia is the occurence of seizures (convulsions) in a pregnant woman. The seizures are unrelated to brain conditions and usually happen after the 20th week of pregnancy.

See also: Preeclampsia

Alternative Names

Causes

The cause of eclampsia is not well understood. Researchers believe a person's genes, diet, blood vessels, and neurological factors may play a role. However, no theories have yet been proven.

Eclampsia follows preeclampsia, a serious complication of pregnancy marked by high blood pressure, weight gain, and protein in the urine.

It is difficult to predict which women with preeclampsia will go on to have seizures. Women with very high blood pressure, headaches, vision changes, or abnormal blood tests have severe preeclampsia and are at high risk for seizures.

The rate of eclampsia is approximately 1 out of 2000 to 3000 pregnancies. The following increase a woman's chance for preeclampsia: 

• First pregnancies
• Teenage pregnancies
• Being 35 or older
• Being African-American
• Multiple pregnancies (twins, triplets, etc.)
• History of diabetes, hypertension, or renal (kidney) disease

Symptoms

• Seizures
• Severe agitation
• Unconsciousness
• Muscle aches and pains 

Symtoms of preeclampsia include swelling of hands and face, gaining more than 2 pounds per week, headache, vision problems, and stomach pain. See preeclampsia.

Exams and Tests

The health care provider will perform a physical exam and rule out other possible causes of seizures. Blood pressure and breathing rate will be checked and monitored. Blood tests may be performed to check:

• Uric acid
• Creatinine (to evaluate kidney function)
• Liver function
• Platelet count

Treatment

A woman with eclampsia should be continously monitored. Delivery is the treatment of choice for eclampsia in a pregnancy over 28 weeks. For pregnancies less than 24 weeks, the start of labor is recommended, although the baby may not survive. 

Prolonging pregnancies in which the woman has eclampsia results in danger to the mother and infant death in approximately 87% of cases.

Women may be given medicine to prevent seizures (anticonvulsant). Magnesium sulfate is a safe drug for both the mother and the baby.

Medication may be used to lower the high blood pressure. The goal is to manage severe cases until 32-34 weeks and mild cases until 36 weeks of the pregnancy have passed. The condition is then relieved with the delivery of the baby. Delivery may be induced if blood pressure stays high despite medication.

Outlook (Prognosis)

Women in the United States rarely die from eclampsia. 

Possible Complications

There is a higher risk for placenta seperation (placenta abruptio) with preeclampsia or eclampsia. There may be baby complications due to premature delivery.

When to Contact a Medical Professional

Call your health care provider or go to the emergency room if any symptoms of eclampsia or preeclampsia. Emergency symptoms include seizures or decreased consciousness.

Prevention

There is no known prevention. However, it is important for all pregnant women to get early and ongoing medical care. This allows for the early diagnosis and treatment of conditions such as preeclampsia. Treatment of preeclampsia may prevent eclampsia from occurring.

ACOG Practice Bulletin Committee. Diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol. 2002 Jan;99(1):159-67.

Gabbe SG, Niebyl JR, Simpson JL. Obstetrics - Normal and Problem Pregnancies. 4th ed. New York, NY: Churchill Livingstone; 2002:974-983.

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