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Eclampsia

Pregnancy - eclampsia; Preeclampsia - eclampsia; High blood pressure - eclampsia; Seizure - eclampsia; Hypertension - eclampsia

 

Eclampsia is the new onset of seizures or coma in a pregnant woman with preeclampsia. These seizures are not related to an existing brain condition.

Causes

 

The exact cause of eclampsia is not known. Factors that may play a role include:

  • Blood vessel problems
  • Brain and nervous system (neurological) factors
  • Diet
  • Genes

Eclampsia follows a condition called preeclampsia. This is a complication of pregnancy in which a woman has high blood pressure and other findings.

Most women with preeclampsia do not go on to have seizures. It is hard to predict which women will. Women at high risk of seizures often have severe preeclampsia with findings such as:

  • Abnormal blood tests
  • Headaches
  • Very high blood pressure
  • Vision changes
  • Abdominal pain

Your chances of getting preeclampsia increase when:

  • You are 35 or older.
  • You are African American.
  • This is your first pregnancy.
  • You have diabetes, high blood pressure, or kidney disease.
  • You are having more than 1 baby (such as twins or triplets).
  • You are a teen.

 

Symptoms

 

Symptoms of eclampsia include:

  • Seizures
  • Severe agitation
  • Unconsciousness

Most women will have these symptoms of preeclampsia before the seizure:

  • Headaches
  • Nausea and vomiting
  • Stomach pain
  • Swelling of the hands and face
  • Vision problems, such as loss of vision, blurred vision, double vision, or missing areas in the visual field

 

Exams and Tests

 

The health care provider will do a physical exam to look for causes of seizures. Your blood pressure and breathing rate will be checked regularly.

Blood and urine tests may be done to check:

  • Blood clotting factors
  • Creatinine
  • Hematocrit
  • Uric acid
  • Liver function
  • Platelet count
  • Protein in the urine

 

Treatment

 

The main treatment to prevent severe preeclampsia from progressing to eclampsia is giving birth to the baby. Letting the pregnancy go on can be dangerous for you and the baby.

You may be given medicine to prevent seizures. These medicines are called anticonvulsants.

Your provider may give medicine to lower high blood pressure. If your blood pressure stays high, delivery may be needed, even if it is before the baby is due.

 

Possible Complications

 

Women with eclampsia or preeclampsia have a higher risk for:

  • Separation of the placenta (placenta abruptio)
  • Premature delivery that leads to complications in the baby
  • Blood clotting problems
  • Stroke

 

When to Contact a Medical Professional

 

Call your provider or go to the emergency room if you have any symptoms of eclampsia or preeclampsia. Emergency symptoms include seizures or decreased alertness.

Seek medical care right away if you have any of the following:

  • Bright red vaginal bleeding
  • Little or no movement in the baby
  • Severe headache
  • Severe pain in the upper right abdominal area
  • Vision loss
  • Nausea or vomiting

 

Prevention

 

Getting medical care during your entire pregnancy is important in preventing complications. This allows problems such as preeclampsia to be detected and treated early.

Getting treatment for preeclampsia may prevent eclampsia.

 

 

References

American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-1131. PMID: 24150027 www.ncbi.nlm.nih.gov/pubmed/24150027.

Markham KB, Funai EF. Pregnancy-related hypertension. In: Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore TR, Greene MF, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 48.

Salhi BA, Nagrani S. Acute complications of pregnancy. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 178.

Sibai BM. Preeclampsia and hypertensive disorders. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 31.

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  • Preeclampsia

    Preeclampsia - illustration

    Preeclampsia is the development of swelling, elevated blood pressure, sudden and rapid weight gain and protein in the urine during pregnancy. The exact cause is unknown, but it occurs in approximately 5% of the population.

    Preeclampsia

    illustration

    • Preeclampsia

      Preeclampsia - illustration

      Preeclampsia is the development of swelling, elevated blood pressure, sudden and rapid weight gain and protein in the urine during pregnancy. The exact cause is unknown, but it occurs in approximately 5% of the population.

      Preeclampsia

      illustration

    Tests for Eclampsia

     
       

      Review Date: 1/14/2018

      Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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