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.
Symptoms 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. Preeclamptic symptoms may be present for some days or weeks before the seizure takes 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.
Treatment Prevention of eclampsia by dealing with pre-eclamptic symptoms is the best management, but even this may not prevent convulsions. Hospital treatment is essential if eclampsia develops, preferably in a specialist unit. The treatment of the seizures is that generally applicable to convulsions of any kind, with appropriate sedatives given such as intravenous DIAZEPAM. HYDRALLAZINE intravenously should also be administered to reduce the blood pressure. Magnesium sulphate given intramuscularly sometimes helps to control the ﬁts. The baby’s condition should be monitored throughout.
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.)
Women who have suﬀered from eclampsia are liable to suﬀer a recurrence in a further preganancy. Careful monitoring is required. There is a self-help organisation, Action on Pre-eclampsia (APEC), to advise on the condition.