What is it:

Eclampsia is a serious condition that can occur during pregnancy. It is characterized by a blood pressure over 140/90 mmHg, the presence of protein in the urine and swelling throughout the body.

This condition is most common in the last 3 weeks of pregnancy, but can occur anytime after the 20th week of gestation, during labor or even after labor.

When left untreated, eclampsia can cause serious harm to the woman or baby, and can be life-threatening. For this reason, it is important for women to keep-up with all regular prenatal appointments, so that any abnormalities in the pregnancy can be identified and treated early on.

Main symptoms

The symptoms associated with eclampsia include:

Seizures
Intense headaches
High blood pressure
Rapid weight gain from fluid retention
Swelling of the hands and feet
Loss of protein through the urine
Ringing in the ears
Intense belly ache
Vomiting
Vision changes

Seizures from eclampsia are usually generalized and last for about one minute. They can develop into a coma.

Post-partum eclampsia

Eclampsia can also emerge after labor, particularly in women who experienced pre-eclampsia during pregnancy. Therefore, it is just as important for women to be assessed immediately after labor to ensure abnormalities do not develop. Women should only be discharged after blood pressure has normalized and symptoms have improved.

What causes eclampsia?

The causes of eclampsia are associated with the initial implantation and the growth of blood vessels within the placenta. These factors can alter the woman's blood pressure.

Other factors associated with a higher risk for eclampsia include:

Age, particularly women over 40 years or under 18 years of age
Family history of eclampsia
Twin pregnancy
Women with high blood pressure
Obesity
Diabetes
Chronic kidney disease
Women with autoimmune diseases, like lupus

The risk for eclampsia can be reduced by managing blood pressure during pregnancy and ensuring all prenatal testing is adequately completed.

Treatment options

Eclampsia does not respond well to diuretics or a low-salt diet, as managing hypertension would. The treatment for this condition typically involves the following approaches:

1. Administering magnesium sulfate

IV magnesium sulfate is the most common way to manage cases of eclampsia. It helps to prevent seizures and the development of a coma. This treatment is done in a hospital setting and administered by a health care professional.

2. Rest

While admitted to the hospital, women are advised to rest as much as possible. Ideally, they should rest on their right side in order to promote blood flow to the baby.

3. Inducing labor

Delivering the baby is the only way to fully cure eclampsia, however labor can be delayed with medications to ensure the baby is able to develop in-utero as much as possible.

During this treatment, women should be frequently monitored, every 6 hours, to ensure the eclampsia does not worsen. If improvements or stability are not possible, the doctors may opt to induce labor as quickly as possible, so that eclampsia seizures and other complications can be avoided.

Although eclampsia usually resolves following delivery, other complications can emerge in the following days. Therefore, women should continue to be closely monitored for signs of eclampsia. They may remain admitted for days to weeks, depending on the severity of the condition and the risk for other complications.

Possible complications

Eclampsia can lead to come complications, mainly when it is not rapidly treated. One of the pain complications if HELLP syndrome, which is a serious condition associated with decreased blood flow. It causes destruction of red blood cells and platelets, as well as liver injury, leading to elevated hepatic enzymes and bilirubin levels in the blood.

Other possible complications are decreased blood flow to the brain, leading to brain injury, fluid retention in the lungs, difficulty breathing, kidney failure or liver failure.

Babies may also be affected by eclampsia, and may experience abnormal development or may be born prematurely. In some cases, the baby may not fully developed, and may have respiratory difficulties as a result. These babies should be closely monitored by a neonatologist, who might advise admission to the NICU.