Eclampsia (toxemia of pregnancy)

Abdomen | Gynecology | Eclampsia (toxemia of pregnancy) (Disease)


Description

Eclampsia an acute and life-threatening complication of pregnancy, is characterized by the appearance of tonic-clonic seizures, usually in a patient who had developed pre-eclampsia. (Preeclampsia and eclampsia are collectively called Hypertensive disorder of pregnancy and toxemia of pregnancy)

Typically patients show signs of pregnancy-induced hypertension and proteinuria prior to the onset of the hallmark of eclampsia, the eclamptic convulsion. Other cerebral signs may precede the convulsion such as nausea, vomiting, headaches, and cortical blindness. In addition, with the advancement of the pathophysiological process, other organ symptoms may be present including abdominal pain, liver failure, signs of the HELLP syndrome, pulmonary oedema, and oliguria.

The foetus may already have been compromised by intrauterine growth retardation, and with the toxemic changes during eclampsia may suffer foetal distress. Placental bleeding and placental abruption may occur.

Causes and Risk factors

Eclampsia includes seizures and coma that happen during pregnancy but are not due to preexisting or organic brain disorders. A woman with eclampsia has severe symptoms of preeclampsia during pregnancy. Preeclampsia turns into eclampsia when a woman develops serious central nervous system symptoms, such as generalized tonic-clonic seizures or coma.

Gestational hypertension can develop into preeclampsia. This condition occurs most often in young women with a first pregnancy. It is more common in twin pregnancies, in women over the age of 35, in women with chronic hypertension or who had hypertension in a previous pregnancy, in African-American women, and in women with diabetes.

Diagnosis and Treatment

Preeclampsia is diagnosed by high blood pressure and protein in the urine after the twentieth week of pregnancy. Preeclampsia occurs in about 7 out of 100 pregnancies. The cause for preeclampsia is unknown. Up to 2 out of every 100 women with preeclampsia develop eclampsia, which is a life threatening illness. ...