What are the other Names for this Condition? (Also known as/Synonyms)

• Eclamptic Seizure
• Hypertension-Eclampsia
• Pregnancy-Eclampsia

What is Eclampsia? (Definition/Background Information)

• Eclampsia is the occurrence of seizures in pregnant women diagnosed with preeclampsia. Preeclampsia is a relatively common condition that is characterized by gestational high blood pressure, protein in urine, and edema, typically after 34 weeks of pregnancy
• However, Eclampsia is generally rare. Women in their first pregnancy, teenage girls who are pregnant, and pregnant women over the age of 40 are more vulnerable to the condition
• Eclampsia is preeclampsia with seizures and this may lead to stroke, brain damage, liver and kidney failure, as well as premature separation of placenta from the uterus
• The condition is treated using medications to control high blood pressure and seizures. If the blood pressures is not controlled, then the baby is delivered by induction of labor or Cesarean section, as determined by a healthcare provider
• Proper prenatal care can lead to early detection and management of preeclampsia, thereby preventing the onset of Eclampsia. Complications from Eclampsia can be life-threatening in pregnant women, particularly in those countries where access to prenatal care is limited or inadequate

Who gets Eclampsia? (Age and Sex Distribution)

• Eclampsia is a rare condition affecting less than 200,000 pregnant women annually. It occurs in less than 0.2% of all pregnancies
• The condition is most often seen in first pregnancies, pregnant teens, and pregnant women over 40 years of age
• Eclampsia is reported worldwide, but is more common in women from lower socioeconomic backgrounds with poor healthcare access

What are the Risk Factors for Eclampsia? (Predisposing Factors)

Preeclampsia is the most important risk factor for Eclampsia. Apart from this, there are several other risk factors that include:

• Maternal age over 35 years
• Pregnancy during teenage
• Fetal demise in a previous pregnancy
• First pregnancy
• Family history of preeclampsia; personal history of preeclampsia
• Multiple pregnancies; more than one fetus (such as twins, triplets, etc.)
• Very short or very long gap between the previous and current pregnancy
• Obesity
• Uncontrolled diabetes
• Conception with in-vitro fertilization
• Carrying a male fetus
• Current pregnancy with a new partner, which is different from the previous pregnancy
• History of hypertension before pregnancy
• History of kidney disease prior to pregnancy
• Autoimmune disorders
• Antiphospholipid syndrome
• Smoking habit
• Living in underdeveloped countries with no or minimal access to prenatal health care

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Eclampsia? (Etiology)

Eclampsia may be caused by the progression of a pre-existing condition called preeclampsia, which is the development of high blood pressure, protein in urine, and edema during pregnancy.

The following are some suspected causes of Eclampsia:

• Structurally (under-developed, narrow) and functionally compromised blood vessels to the placenta
• Abnormal response to hormone signaling in these blood vessels, restricting blood flow to the placenta
• Formation of a benign mass in the uterus, known as molar pregnancy
• These abnormal blood vessels may be caused by
  • An autoimmune disorder
  • One’s genetic predisposition
  • Damage to uterine blood vessels
  • Abnormality in uterine vasculature

What are the Signs and Symptoms of Eclampsia?

The signs and symptoms of Eclampsia may include:

• Seizures, which may be self-limiting (usual duration 60-75 seconds)
• Irritability
• Unconsciousness

The above signs and symptoms may be preceded by, and/or coexist with the following:

• High blood pressure
• Edema
• Protein in urine
• Nausea and vomiting
• Pain under the ribs on the right side
• Persistent headaches
• Blurred vision; sensitivity to light
• Confusion

In the fetus, fetal bradycardia (decreased heart rate) lasting 3-5 minutes following an eclamptic seizure may be observed.

How is Eclampsia Diagnosed?

The diagnosis of Eclampsia is made on the basis of the following tests and exams:

• A thorough physical examination
• Assessment of signs and symptoms, particularly noting for:
  • Seizures
  • Symptoms of preeclampsia, such as high blood pressure (over 140/90 mm/Hg), and edema
• Evaluation of personal and family history
• Blood tests that may include:
  • Complete blood count (CBC) 
  • Hematocrit
  • Blood creatinine levels
  • Checking uric acid levels
  • Blood clotting tests
  • Liver enzymes
• Urine tests for checking protein in urine
• Magnetic resonance imaging (MRI) scan of the brain (of the pregnant woman) to assess for any damage
• Ultrasound imaging scan of the fetus
• Non-stress test, a non-invasive test where a device monitors the fetal heartbeat for distress (cardiotocography)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Eclampsia?

The potential complications of Eclampsia that may involve several organs of the body may include:

• Aspiration pneumonia due to seizures
• Rupture of liver
• Kidney failure
• Cardiac arrest
• Intracranial bleeding 
• Premature separation of the placenta from uterus 
• Disseminated intravascular coagulation (DIC)
• Stroke
• Coma
• Restricted growth in the fetus
• Intra-uterine asphyxiation may lead to fetal demise
• Premature delivery may be fatal for the newborn in some cases

How is Eclampsia Treated?

The options for treatment of Eclampsia may depend on the severity of the condition and may include:

• Administration of anticonvulsant medications, such as magnesium sulfate, to control seizures
• Medication to reduce blood pressure in the mother: The various medications used to lower blood pressure include alpha blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, calcium channel blockers, central alpha agonists, diuretics, and vasodilators, among others
• If the blood pressure remains high despite treatment, then based on the healthcare provider’s evaluation of the condition, the following may be considered:
  • Induction of labor, if fetal distress is observed
  • Delivery of baby via Caesarian section (C-section), if warranted

Note: When a woman is having an eclamptic seizure, protecting her airway and tongue, maintenance of airway patency (keeping the airway open), and prevention of aspiration should be the first priority.

How can Eclampsia be Prevented?

• Seeking prenatal care during pregnancy; seeking continual care throughout pregnancy is highly recommended and advised for the prevention of preeclampsia, and subsequently, Eclampsia
• If two or more risk factors for Preeclampsia are present, a low-dose of aspirin after 12 weeks of pregnancy may be recommended to prevent complications, such as Eclampsia, by the healthcare provider
• Pregnant women with preeclampsia may be prescribed an anticonvulsant prophylactically (such as magnesium sulphate) in order to prevent Eclampsia; although, recurrent seizures are still possible with this treatment
• Educating oneself on Eclampsia, being aware of the signs and symptoms, and seeking medical help when they occur may help avoid aggravation of the condition and prevention of complications associated with the condition
• Active research is currently being performed to explore the possibilities for treatment and prevention of conditions such as Eclampsia

What is the Prognosis of Eclampsia? (Outcomes/Resolutions)

• With a timely intervention and treatment of preeclampsia and other (preceding) maternal conditions, the prognosis of Eclampsia may be favorable. The symptoms are known to disappear within 6 weeks following delivery of the child
• Development of complications, such as separation of placenta from the uterus and blood coagulation issues, may make the prognosis unfavorable or guarded
• Brain damage may result in permanent neurological damage and is the most common cause of death in women with Eclampsia. Strokes account for 15-20% of deaths from Eclampsia
• In women with Eclampsia, the risk for recurrence in subsequent pregnancies is about 2%
• Study reports indicate that the outcomes are better (for both the mother and baby) in developed nations in comparison to certain underdeveloped or developing countries, who sometimes have limited or no access to adequate prenatal and postnatal care

Additional and Relevant Useful Information for Eclampsia:

The following article link will help you understand other pregnancy-related conditions:

https://www.dovemed.com/diseases-conditions/pregnancy-related-disorders/