A rare disorder in which convulsions occur during late pregnancy (see also PREGNANCY AND LABOUR – Increased blood pressure). This condition occurs in around 50 out of every 100,000 pregnant women, especially in the later months and at the time of delivery, but in a few cases only after delivery has taken place. The cause is not known, although cerebral OEDEMA is thought to occur. In practically all cases the KIDNEYS are profoundly affected. Effective antenatal care should identify most women at risk of developing eclampsia.
Warning symptoms include dizziness, headache, oedema, vomiting, and the secretion of albumin (protein) in the urine. These are normally accompanied by a rise in blood pressure, which can be severe. Symptoms of PRE-ECLAMPSIA may be present for some days or weeks before the seizures take place and, if a woman is found to have these during antenatal care, preventive measures must be taken. Untreated, CONVULSIONS and unconsciousness are very likely, with serious migraine-like frontal headache and epigastric pain the symptoms.
Urgent delivery of the baby, if necessary by CAESAREAN SECTION, is the most effective ‘treatment’ for a mother with acute eclampsia. (See PREGNANCY AND LABOUR.) Prevention of eclampsia by dealing with PRE-ECLAMPSIA symptoms is the best management, but even this may not prevent convulsions. Hospital treatment is essential if eclampsia develops, preferably in a specialist unit. Seizures may be treated with drugs such as intravenous DIAZEPAM, or intramuscular magnesium sulphate. HYDRALLAZINE may be administered intravenously to reduce the blood pressure.
Women who have suffered from eclampsia are liable to suffer a recurrence in a further pregnancy, and careful monitoring is required.