Eclampsia is the onset of convulsion in a pregnant woman with high blood pressure. It is one of the causes of death in pregnant women. High blood pressure complicates 5 percent of all pregnancy worldwide. Presence of high blood pressure, protein in urine and convulsion is eclampsia.
Eclampsia is the commonest cause of convulsion in pregnancy. It affects pregnant women in low income countries. Though ecclampsia can occur in developed countries, It is common in countries with poor health care system. Poor treatment of preeclampsia will also cause eclampsia.
What is preeclampsia?. This is the presence of blood pressure ≥ 140/90 in pregnancy with protein in urine.
There are many risk factors that predisposes to preeclampsia in pregnancy. This has been outlined in this article.
However, Not all pregnant women with high blood pressure will develop convulsion. Convulsion in eclampsia is short lived and resolves on its own.
Therefore, quick treatment is necessary for all patients with eclampsia. This is because eclampsia can cause death to the mother and baby.
Antenatal clinic is your first contact with your doctor. Your blood pressure is checked and routine blood test is done. Your blood pressure is monitored throughout your clinic visits.
Severe preeclampsia is the presence of high blood pressure more than 160/100 mmHg. Preeclampsia symptoms include the following.
- Presence of frontal headache that is persistent
- blurring of vision or visual disturbances
- right upper abdomen pain
- Upper abdomen pain or epigastric pain
- vomiting and nausea
Pregnant women with preeclampsia require treatment. This helps to prevent onset of eclampsia. Eclampsia is more common in pregnant women who did not attend antenatal care. If you are pregnant, it is necessary to see your doctor.
What Are The Risk Factor Of Eclampsia
The common risk factors that predispose to eclampsia are
- First time moms
- Multiple pregnancies
- Your body mass index
- Preexisting conditions like hypertension
- Family history of eclampsia is a risk factor
- Poor equipped health centers
What Causes Convulsion In pregnancy
The most common cause of convulsion in pregnancy is eclampsia. But this does not rule out other causes.
Other common causes of convulsion in pregnancy are
- Epilepsy. But they do not have high blood pressure and protein in urine
- Meningitis. However, patients develop stiff neck and high body temperature.
Other causes of convulsion in pregnancy include
- cerebral malaria is common in developing countries. There is no high blood pressure or protein in urine
- HIV and AIDS
- Diabetic coma in pregnancy
What Causes Eclampsia In Pregnancy
The cause of eclampsia is still unknown. However, it is due to blood vessel spasm in vital organs. Some of theses organs include the brain, heart, lungs and liver.
If it affects the brain, it will cause cerebral edema.
What Are Eclampsia Symptoms And Signs
- Frontal headache
- Blurring of vision
- Upper abdominal pain
- Edema of the hands, feets and face
Blood pressure is atleast 140/90mmHg. There is also large amount of protein in urine.
What Test Can Be Done In Eclampsia?
Basic test done for eclampsia include
- Urinalysis– Your urine is collected for a 24 hour period. Presence of protein more than 300mg is significant. Urine dipstick test is an alternative. Urine dipstick test of ≥1+ is significant.
- Blood pressure– high blood pressure is a problem in pregnancy. Blood pressure ≥140/90 is abnormal.
- Complete blood count– This is important to examine blood cell indices. This include your red blood cell, white blood cell and platelet levels. Platelets help in would healing process. They are deficient in patients with complicated eclampsia. This can result to bleeding.
- Abdominal scan– This is important to evaluate the baby’s clinical condition. The age of the baby is also assessed. This important to for best treatment. Furthermore, other vital organs like the liver and kidneys are also evaluated.
What Is The Treatment Of Eclampsia
The cure for eclampsia is delivery of the baby and placenta. This is same with preeclampsia.
You can read the complete guide to preeclampsia diagnosis and treatment.
Poor treatment of preeclampsia is a danger sign for eclampsia. Most pregnant women with eclampsia are unconscious or in coma.
Your doctor will quickly ensure the airways are patent. Mucus is suctioned from the mouth and nostril. Next, your doctor will ensure breathing and blood flow. This is by checking your pulse.
Pregnant women with convulsion should be treated with care. It should be aborted quickly. Convulsion in eclampsia is shortlived and self limiting.
Left lateral position is the best choice. This is to prevent the baby’s weight from affecting blood flow.
Quick delivery is the ultimate goal for eclampsia treatment.
There are 3 goals to eclampsia treatment.
- To control convulsion in the fastest way
- The control of high blood pressure
- To deliver the baby by the safest route.
How Is Convulsion Treated In Eclampsia
Convulsion in common in eclamptic women. Quick treatment of convulsion is therefore important. The drug of choice is magnesium sulphate. It helps to abort convulsion and prevent recurrent seizure. It is the best anti seizure drug used in eclampsia treatment.
However, magnesium sulphate is toxic at high doses. It requires close monitoring. Your doctor will monitor your number of breaths per minute. Your breaths per minute should be more that 12. Also, your doctor will monitor reflexes. Absent or weak reflexes is a danger sign. Are you making adequate urine?. This is a danger sign. urine output less than 25 mil per hour is a danger sign.
But there is good news too. High toxic levels of magnesium sulphate is treated with calcium gluconate.
How To Treat High Blood Pressure In Eclampsia
The drug of choice for high blood pressure treatment is hydralazine and labetalol.
High blood pressure is treated with Hydralazine. It acts on blood vessels to dilate them. This will result to increase blood supply to vital organs. Which include the kidneys and placenta. More blood to the placental means more blood to the baby. However, hydralazine has its side effects. These include awareness of heartbeat, restlessness, headache.
Labetalol is safe in pregnancy. It lowers blood pressure in pregnant eclamptic women. However, it is used short term. This is because it affects the growth of your baby.
How To Deliver Your Baby In Eclampsia
All pregnant women with eclampsia should deliver vaginally, except where not indicated.
The choice of delivery depends on these factors
- The risk to the mothers health
- If the baby is in distress
- The age of the pregnancy
Pregnancy at 38 weeks will be induced. Induction of labor is ripening the cervix to start labor. However, if your baby is less than 32 to 34 weeks, you will need steriods. This is to help your baby’s immature lungs. Also, prolonged labor may require forceps delivery.
The need for quick intervention might require urgent action. This maybe due to fetal distress and risk to the mother. The use of cesarean section is an option.
What Are Eclampsia Complications
- Kidney failure.
- heart failure
- High body temperature
- Premature babies
- HELLP syndrome- this comprises of heamolysis, elevated liver enzymes and low platelets
- Death to mother an baby
Let us know if you have high blood pressure in pregnancy. Are u a doctor? lets share your experiences.