Eclampsia

What is eclampsia?

Eclampsia is a severe complication of preeclampsia. It’s a rare but serious condition where high blood pressure results in seizures during pregnancy.
Seizures are periods of disturbed brain activity that can cause episodes of staring, decreased alertness, and convulsions (violent shaking). Eclampsia affects about 1 in every 200 women with preeclampsia. You can develop eclampsia even if you don’t have a history of seizures.

Symptoms

What are the symptoms of eclampsia?

Because preeclampsia can lead to eclampsia, you may have symptoms of both conditions. However, some of your symptoms may be due to other conditions, such as kidney disease or diabetes. It’s important to tell your doctor about any conditions you have so they may rule out other possible causes.
The following are common symptoms of preeclampsia:

• swelling in your face or hands
• headaches
• excessive weight gain
• nausea and vomiting
• vision problems
• difficulty urinating

The following are common symptoms of eclampsia:

• seizures
• loss of consciousness
• agitation
• headaches or muscle pain
• upper right abdominal pain

Causes

What causes eclampsia?

Eclampsia often follows preeclampsia, which is characterized by high blood pressure after the 20th week of pregnancy and protein in the urine. If your preeclampsia worsens and affects your brain, causing seizures, you have developed eclampsia.
Doctors don’t know what causes preeclampsia, but they can explain how the symptoms of preeclampsia can lead to eclampsia.

High blood pressure

Preeclampsia is when your blood pressure, or the force of blood against the walls of your arteries, becomes high enough to damage your arteries and other blood vessels. Damage to your arteries may restrict blood flow. It can produce swelling in the blood vessels in your brain and to your growing baby. If this swelling interferes with your brain’s ability to function, seizures may occur.

Proteinuria

Preeclampsia commonly affects kidney function. Protein in your urine, also known as proteinuria, is a key sign of the condition. Each time you have a doctor’s appointment, your urine will be tested for protein.
Typically, your kidneys filter waste from your blood and create urine from these wastes. However, the kidneys try to retain nutrients in the blood, such as protein, for redistribution to your body. If the kidneys’ filters, called glomeruli, are damaged, protein can leak through them and excrete into your urine.

Who is at risk for eclampsia?

If you have or have had severe preeclampsia, you may be at risk for eclampsia.
Other risk factors for seizures during pregnancy include:

• hypertension (high blood pressure)
• headaches
• being older than 35 years or younger than 20 years
• pregnancy with twins
• first-time pregnancy
• history of poor diet or malnutrition
• diabetes or another condition that affects your blood vessels

Eclampsia and your baby

Preeclampsia and eclampsia affect the placenta, which is the organ that delivers oxygen, blood, and nutrients from the mother’s blood to the fetus. When high blood pressure reduces blood flow in the heart and vessels, the placenta may be unable to function properly. This may result in your baby being born with a low birth weight or other health problems.
Problems with the placenta often require preterm delivery for the health and safety of the baby. In rare cases, these conditions cause stillbirth.

Diagnosis

How is eclampsia diagnosed?

If you already have a preeclampsia diagnosis or have a history of it, your doctor will order tests to determine if your preeclampsia has happened again or gotten worse. If you don’t have preeclampsia, your doctor will order tests for preeclampsia as well as others to determine why you’re having seizures. These tests can include:

Blood tests

Your doctor may order several types of blood tests to assess your condition. These tests include a hematocrit, which measures how many red blood cells you have in your blood, and a platelet count to see how well your blood is clotting. Blood tests will also help examine your kidney and liver function.

Creatinine test

Creatinine is a waste product created by the muscles. Your kidneys should filter most of the creatinine from your blood, but if the glomeruli get damaged, excess creatinine will remain in the blood. Having too much creatinine in your blood may indicate preeclampsia, but it doesn’t always.

Urine tests

Your doctor may order urine tests to check for the presence of protein and its excretion rate.

Treatment

What are the treatments for eclampsia?

Delivering your baby is the only way to cure preeclampsia and eclampsia. If your doctor diagnoses you with preeclampsia, they may monitor your condition and treat you with medication to prevent it from turning into eclampsia. Medications and monitoring will help keep your blood pressure within a safer range until the baby is mature enough to deliver.
If you do develop eclampsia, your doctor may deliver your baby early, depending on how far along you are in your pregnancy. Early delivery may occur between 32 and 36 weeks of pregnancy if you have life-threatening symptoms or if medication doesn’t work. You may need to be hospitalized until you can deliver your baby.

Medications

Medications to prevent seizures, called anticonvulsants drugs, may be necessary. You may need medication to lower blood pressure if you have high blood pressure. You may also be placed on a low-dose aspirin.

Home care

Pay attention to your diet. Ensure you get enough calcium. You may have to go in for fetal monitoring and checkups more often. This monitoring may be done from your own home if those services are offered in your area.
Taking all prescribed medications, getting rest, and monitoring any changes in your condition are critical for managing preeclampsia and eclampsia. With proper care and careful monitoring, you can deliver without complications.

What is the long-term outlook?

Your symptoms should disappear once you have your baby. That said, you will still have a greater chance of blood pressure issues in your next pregnancy.
If complications occur, you may have a medical emergency such as placental abruption. Placental abruption is a condition that causes the placenta to detach from the uterus. This requires immediate emergency cesarean delivery to save the baby. The baby may be very ill or may even die.
However, getting the proper medical care for preeclampsia may prevent eclampsia. Go to your prenatal visits as recommended by your doctor to have your blood pressure, blood, and urine monitored. Make sure to talk to your doctor about any symptoms you have, as well.