Eclampsia Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Eclampsia is a disorder during pregnancy, during childbirth, or after childbirth that arises as a result of complications from preeclampsia. Generally, eclampsia is characterized by the onset of seizures and can be accompanied by a coma.
In preeclampsia, high blood pressure levels in the mother will reduce the blood supply to the fetus. In effect, the fetus does not receive as much oxygen and nutrients as it should.
Most cases of eclampsia occur in the third trimester of pregnancy, with about 80 percent of eclamptic seizures occurring intrapartum or within the first 48 hours after delivery.
Rare cases have been reported before 20 weeks gestation or up to 23 days postpartum.
Eclampsia
| Medical specialist | Obstetrics and gynecology specialist |
| Symptom | Severe headache, swelling of the face or hands, visual disturbances, nausea, vomiting, seizures |
| risk factor | Family history of preeclampsia, history of preeclampsia in a previous pregnancy |
| How to diagnose | History, physical examination, blood test, urine test |
| Treatment | Give birth to the unborn baby |
| Drug | Magnesium sulfate, nifedipine |
| Complications | Bleeding, kidney disorders, liver disorders, coma |
| When to see a doctor? | Immediately after feeling the symptoms of eclampsia |
Symptom
Symptoms of eclampsia include:
- Severe headache in the front or back of the head, followed by abnormally high blood pressure. The headaches are persistent and are not relieved by aspirin or other headache medications
- Impaired vision. Sufferers will see flashes of light, blurred vision, and sometimes temporary blindness can occur
- Excessive weight gain
- Nausea and vomiting
- Abdominal pain, especially in the upper right abdomen
- Common signs of preeclampsia (high blood pressure, swelling of the face or hands, and protein in the urine)
- Seizures that may be followed by coma
Reason
Until now, experts do not know the exact cause of eclampsia. However, it is suspected that this condition is caused by the abnormal formation and function of the placenta.
Because eclampsia is a continuation of preeclampsia, most recent studies have focused on determining the risk factors for preeclampsia early in pregnancy.
This is done to prevent or predict the development of eclampsia in the future.
Risk Factors
Eclampsia usually occurs if preeclampsia is not treated or is not recognized beforehand. In addition, there are also several risk factors that can cause eclampsia, namely:
- First pregnancy
- Prior history of preeclampsia
- Family history of preeclampsia
- Twin pregnancy
- Pregnancy at the age of under 20 years
- Pregnancy at the age of over 35 years
- Obesity
- Chronic hypertension
- Gestational diabetes
- Kidney disorders
Diagnosis
If you have previously been diagnosed with preeclampsia, the doctor will suggest supporting examinations. The goal is to see if preeclampsia gets worse or recurs.
However, if you didn’t have preeclampsia before, the doctor will just do an eclampsia check.
The types of tests that can be done to determine the cause of seizures during pregnancy are:
- Blood test. An examination is done to determine the number of platelets and blood clotting factors.
- Urine test. The goal is to check for the possibility of protein in the urine.
- Creatinine test. High levels of creatinine (a waste created by muscles and supposed to be filtered by the kidneys) in the blood indicate preeclampsia.
Diagnosis to determine that eclampsia has occurred can be done by:
- Physical examination. At the initial stage, which lasts 30-35 seconds, the hands and eyelids tremble, the eyes open with a vacant look. The next stage is seizures
- Vital sign check. There was an increase in diastolic blood pressure of 110 mm Hg. Fingertips look bluish. There may be signs of fluid-soaked lungs, which can be accompanied by heart failure
- Supporting investigation. The doctor will do a urine test to see if there is a protein in the urine
Treatment
The main way to deal with eclampsia is to deliver the unborn baby. If the mother is eclampsia and the pregnancy is allowed to continue, it can be fatal for the mother and the fetus.
The treatment for eclamptic seizures is not much different from the treatment for severe preeclampsia.
The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) support the use of magnesium sulfate for the prevention and treatment of seizures in women with preeclampsia or eclampsia.
Other antiseizure drugs, including benzodiazepines and phenytoin, are used for seizures unresponsive to magnesium sulfate.
High blood pressure medications are also given to patients with eclampsia to control blood pressure. Blood pressure medications used in pregnancy, such as labetalol, nifedipine, and hydralazine.
Blood pressure control is also important postpartum because the risk of eclampsia is highest during the 48 hours after birth.
Prevention
To prevent eclampsia from occurring, treatment of preeclampsia must be carried out according to the doctor’s advice.
Studies have shown that low-dose aspirin in women at high risk of preeclampsia can contribute to a reduced risk of preeclampsia, eclampsia, and decreased fetal death.
Of course, giving aspirin must be according to the dose given by the doctor and under close supervision by an obstetrician and gynecologist.
Apart from that, make sure you are diligent with your pregnancy control to the doctor, get enough rest, and always keep an eye on any changes in your body.
Complications
Complications that may occur in eclampsia include:
- Bleeding
- Liver complications
- Kidney complications
- Jaundice or jaundice (yellow eyes and skin)
- Coma
- Premature birth
- Detachment of the placenta from the uterine wall
- Brain damage from seizures