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Eclampsia

  • Definition
    • 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.

  • Alternative Names
    • Pregnancy - eclampsia; Preeclampsia - eclampsia; High blood pressure - eclampsia; Seizure - eclampsia; Hypertension - eclampsia

  • Causes
    • Doctors do not know exactly what causes eclampsia. 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 chance of getting preeclampsia increases 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, but not all, will have 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. Blood pressure and breathing rate will be checked regularly.

      Blood and urine tests may be done to check:

  • 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 prescribe 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 of:

      • Separation of the placenta (placenta abruptio)
      • Premature delivery that leads to complications in the baby
      • Blood clotting problems
  • 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. Practice Guideline WQ244. 2013. Obstet Gynecol. 2013;122(5):1122-31. PMID: 24150027 www.ncbi.nlm.nih.gov/pubmed/24150027.

      Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 178.

      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.

      Sibai BM. Hypertension. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 35.