Eclampsia

Definition

Eclampsia is seizures (convulsions) in a pregnant woman. These seizures are not related to an existing brain condition.

Causes, incidence, and risk factors

Doctors do not know exactly what causes eclampsia. The following may play a role:

  • Blood vessel problems
  • Brain and nervous system (neurological) factors
  • Diet
  • Genes

Eclampsia follows a condition called preeclampsia. This is a serious complication of pregnancy that includes high blood pressure and excess and rapid weight gain.

It is hard to predict which women with preeclampsia go on to have seizures. Women at high risk of seizures have severe preeclampsia and:

  • Abnormal blood tests
  • Headaches
  • Very high blood pressure
  • Vision changes

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 one baby (twins, triplets, etc.)
  • You are a teen

Symptoms

Symptoms of eclampsia include:

  • Muscle aches and pains
  • Seizures
  • Severe agitation
  • Unconsciousness

Symptoms of preeclampsia include:

  • Gaining more than 2 pounds a week
  • Headaches
  • Nausea and vomiting
  • Stomach pain
  • Swelling of the hands and face
  • Vision problems

Signs and tests

The health care provider will do a physical exam to check for possible causes of seizures. Blood pressure and breathing rate will be checked and monitored.

Blood and urine tests may be done to check:

Treatment

Delivering your baby is the main treatment for severe preeclampsia to prevent eclampsia. Allowing the pregnancy to go on can be dangerous to both you and the baby.

You may be given medicine to prevent seizures. These medicines are called anticonvulsants.

Your doctor may prescribe medicine to lower high blood pressure. If your blood pressure stays high, delivery may be needed, even if your baby is premature.

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 problem

Calling your health care provider

Call your health care 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 pain
  • Vision loss
  • Nausea or vomiting.

Prevention

It is important for all pregnant women to get early and ongoing medical care. This allows for early diagnosis and treatment of conditions such as preeclampsia. Treating preeclampsia may prevent eclampsia.

References

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 33. Diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol. 2002;99:159-167.

Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Elsevier Mosby; 2009:chap 176.

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.

Stead LG. Seizures in pregnancy/eclampsia. Emerg Med Clin North Am. 2011;29:109-116.

Review date:
August 2, 2013
Reviewed by:
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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