Eclampsia






ECLAMPSIA

Eclampsia is a rare, but serious complication of pregnancy characterized by an attack of convulsions (abnormal, severe, involuntary muscle movements) that are not caused by other conditions of the brain, such as bleeding in the brain, in a woman with moderate or severe (but not mild) preeclampsia. Eclamptic means pertaining to eclampsia. Eclamptogenic and eclamptogenous means causing eclampsia.

WHAT IS PREECLAMPSIA?

Preeclampsia is a severe condition that occurs in the 2nd half of pregnancy, which is characterized by a sudden onset of high blood pressure with edema (a type of swelling), and/or abnormal amounts of protein in the urine. It is called preeclampsia because it occurs before (which is what "prae" means in Latin) eclampsia.
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WHAT ARE OTHER SIGNS AND SYMPTOMS OF ECLAMPSIA?

In addition to abnormal and severe involuntary muscle movements, eclampsia is also characterized by the following signs and symptoms: high blood pressure, edema (a type of swelling), decreased urination (peeing), abnormal amounts of protein in the blood, and coma. Coma is a severe loss of consciousness caused by poisoning, trauma, or disease.

Some of the abnormal, involuntary movements in eclampsia are described as tonic and clonic. Tonic means that the muscles become tense (for example, the legs, arms, back, and neck are extended), causing the person to fall and lie down stiffly for about 10 to 30 seconds. Clonic means that the muscles switch between being tense and being relaxed. The abnormal muscle movements are caused by involuntary muscle contractions (shortening and thickening of the muscles).

Before the convulsions begin, the woman may experience headache, blurry vision, confusion, and pain in the belly. Breathing difficulties may also occur because muscles in the throat may become narrower, making it more difficult for air to pass through. Other problems can be a temperature up to 104 degrees Fahrenheit, nervousness, severe headaches, blurry vision, and pain in the upper part of the belly. Deep tendon reflexes (a shortening of a stretched muscle that is caused by a sharp tap) can also occur.

WHAT ARE COMPLICATONS OF ECLAMPSIA?

Serious complications can occur before and after birth such as failure of the lungs, liver, or kidney, bleeding in the brain, a buildup of fluid in the lungs, and pneumonia (inflammation the lungs due to infection). Other complications include hemolysis (a breakdown of red blood cells), hypofibrinogenemia (a decrease of a substance in the body known as fibrinogen that causes bleeding to stop), bleeding in the retina (an area at the back of the eye that is sensitive to light), temporary blindness, and placental abruption. Placental abruption refers to when the placenta separates in a pregnancy of 20 weeks or more. The placenta is an organ in the uterus (a hollow organ in which a baby develops) that links the blood supply of the mother to the developing baby and by which the baby can release wastes.

WHEN DOES ECLAMPSIA OCCUR?

About half of all cases of eclampsia occur late in pregnancy (usually after the 20th week), about 33% occur during the actual delivery of the baby, and the rest of the cases occur after the baby has been born (usually within 48 hours after birth).

WHO USUALLY GETS ECLAMPSIA?

Eclampsia tends to occur in women who are pregnant for the first time. It also tends to occur in women who have had little or no health care during pregnancy. Pregnant women with little or no healthcare develop preeclampsia (see beginning of this entry for description) and do not recognize it or get it treated. Thus, the preeclampsia develops into eclampsia.

WHAT CAUSES ECLAMPSIA?

Unfortunately, the cause of eclampsia is unknown. However, one theory is that eclampsia is caused by a poisonous substance produced by the placenta. The placenta is an organ in the uterus (a hollow organ in which a baby develops) that links the blood supply of the mother to the developing baby and by which the baby can release wastes.

IS ECLAMPSIA CAUSED BY EPILEPSY?

No. Epilepsy does not cause eclampsia. Epilepsy is a long-term condition caused by overexcitement of nerve cells in the brain and is usually associated with changes in consciousness and involuntary muscle movements.
HOW IS ECLAMPSIA TREATED?

The first form of treatment is to get the woman to breathe easier. This may require inserting a tube down the windpipe. To stop and prevent further convulsions, drugs known as anticonvulsants (such as magnesium sulfate) may be administered. Convulsions may also be prevented by having the patient lie down in a quiet room that is lit ever so slightly. The mother must also be prevented from harming herself or her baby due to the involuntary movements. This is usually done by restraining the mother.

Drugs to reduce high blood pressure may also be administered. The condition of the baby is monitored regularly. The doctors may also cut open the belly to deliver the baby quicker because eclampsia usually goes away once the baby is born. The baby's heart rate is also monitored throughout the treatment process.
IS IT POSSIBLE FOR THE MOTHER AND BABY TO DIE FROM ECLAMPSIA?

Unfortunately, the answer is yes. About 10% of mothers die due to eclampsia. About 33% to 50% of babies die due to eclampsia, usually because of lack of oxygen. Of these deaths in babies, half occur before birth and half occur after birth. This is why it is important for eclampsia to be treated immediately.

WHAT USUALLY HAPPENS TO THE MOTHER AFTER ECLAMPSIA?

After the baby is born, the blood pressure usually returns to normal within a week. The abnormal amount of protein in the urine usually goes away in six weeks. Convulsions rarely occur after childbirth. However, as mentioned earlier, serious complications can occur after birth such as failure of the lungs, liver, or kidney, bleeding in the brain, a buildup of fluid in the lungs, and pneumonia (inflammation of the lungs due to infection).

HOW OFTEN DOES ECLAMPSIA OCCUR?

Eclampsia occurs in about 0.2% of all pregnancies. This means that for every 1000 pregnant women, 2 will get eclampsia.

WHAT ELSE DOES ECLAMPSIA MEAN?

Eclampsia is also used to describe a condition in domestic animals (those that do not live in the wild), such as dogs and cats, that are producing milk as a result of being pregnant. It is characterized by convulsions that are not caused by other conditions of the brain, such as bleeding in the brain. The chances of developing eclampsia increase as the amount of milk that is produced increases. Death can occur if this condition is not treated successfully. Treatment involves slowly administering calcium (a type of metal) through the veins for 10 to 15 minutes. This is because eclampsia in domestic animals is associated with too little calcium in the blood.

WHAT IS THE ORIGIN OF THE WORD, ECLAMPSIA?

Eclampsia comes from the Greek word "ek" meaning "out," and the Greek word "lampein" meaning "to flash." Put the two words together and you get "to flash out."