Ecalmpsia is a serious complication of pregnancy, characterized by high blood pressure and edema. It is the more severe form of pre-eclampsia.
Pre-eclampsia is a disorder of pregnancy in which there is high blood pressure and either large amounts of protein in the urine or other organ dysfunction. Onset may be before, during, or after delivery. Most often it is during the second half of pregnancy. The seizures are of the tonic–clonic type and typically last about a minute. Following the seizure there is typically either a period of confusion or coma. Complications include aspiration pneumonia, cerebral hemorrhage, kidney failure, and cardiac arrest. Pre-eclampsia and eclampsia are part of a larger group of conditions known as hypertensive disorders of pregnancy.
Recommendations for prevention include aspirin in those at high risk, calcium supplementation in areas with low intake, and treatment of prior hypertension with medications. Exercise during pregnancy may also be useful. The use of intravenous or intramuscular magnesium sulfate improves outcomes in those with eclampsia and is generally safe. This is true in both the developed and developing world. Breathing may need to be supported. Other treatments may include blood pressure medications such as hydralazine and emergency delivery of the baby either vaginally or by cesarean section.
Pre-eclampsia is estimated to affect about 5% of deliveries while eclampsia affects about 1.4% of deliveries. In the developed world rates are about 1 in 2,000 deliveries due to improved medical care. Hypertensive disorders of pregnancy are one of the most common causes of death in pregnancy. They resulted in 29,000 deaths in 2013 – down from 37,000 deaths in 1990. Around one percent of women with eclampsia die.
Typically the pregnant woman develops hypertension and proteinuria before the onset of a convulsion, the hallmark of eclampsia. Eclampsia is preeclampsia and seizures. Other cerebral signs may immediately precede the convulsion, such as nausea, vomiting, headaches, and cortical blindness. If the complication of multi-organ failure ensues, signs and symptoms of those failing organs will appear, such as abdominal pain, jaundice, shortness of breath, and diminished urine output.
The fetus may develop intrauterine growth retardation, and with maternal convulsions, bradycardia, and fetal distress. Placental bleeding, and placental abruption may also occur.
Sometimes the pregnant woman becomes comatose without preceding convulsions. Upon awakening from the coma, some experience amaurosis fugax: a “dark” and “fleeting” unilateral temporary blindness.
Eclampsia, like pre-eclampsia, tends to occur more commonly in first pregnancies and young mothers where it is thought that novel exposure to paternal antigens is involved. Furthermore, women with pre-existing vascular diseases (hypertension, diabetes, and nephropathy) or thrombophilic diseases such as the antiphospholipid syndrome are at higher risk to develop pre-eclampsia and eclampsia. Having a large placenta (multiple gestation, hydatidiform mole) also predisposes women to eclampsia. In addition, there is a genetic component: a woman whose mother or sister had the condition is at higher risk than otherwise. Women who have experienced eclampsia are at increased risk for pre-eclampsia/eclampsia in a later pregnancy. Pulmonary edema is a rather common complication of severe eclampsia affecting approximately 3% of the people with eclampsia: most is caused by too much intravenous fluid.
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Eclampsia. (2016, September 4). In Wikipedia, The Free Encyclopedia. Retrieved 03:47, September 4, 2016, from https://en.wikipedia.org/w/index.php?title=Eclampsia&oldid=737636646