Eclampsia
Key points
- Eclampsia is the occurrence of seizures not attributed to another cause during pregnancy, usually after the 20th week.
- Eclampsia may follow preeclampsia, if that condition cannot be brought under control.
- Because the risk of eclampsia is unpredictable and often not easily related to physical signs such as the degree of high blood pressure, an anticonvulsant (seizure prevention medication) is usually given to women in labor with preeclampsia.
- Maternal deaths caused by preeclampsia or eclampsia are rare in the U.S.
Alternative names
Toxemia with seizures
Definition
Eclampsia is the occurrence of seizures not attributed to another cause during pregnancy, usually after the 20th week.
Causes, incidence, and risk factors
The cause of eclampsia is not well understood. Eclampsia may follow preeclampsia, if that condition cannot be brought under control. Preeclampsia is a serious condition which occurs during pregnancy and is marked by high blood pressure, weight gain, and protein in the urine.
It is difficult to predict which preeclamptic women may go on to have seizures - the hallmark of eclampsia. There is poor correlation between the degree of hypertension present in preeclampsia and the ultimate occurrence of seizures.
The exact cause of preeclampsia has not been identified. Numerous theories of potential causes range from genetic, dietary, vascular (blood vessel), and neurological factors. None of the theories has yet been proven.
Preeclampsia occurs in approximately 5% of all pregnancies. The incidence of eclampsia is approximately 1 out of 2000 to 3000 pregnancies. An increased risk for preeclampsia is associated with first time pregnancies, teenage pregnancies, mothers over the age of 40, African-American women, multiple pregnancies, and women with a history of diabetes, hypertension, or renal (kidney) disease.
Symptoms
ECLAMPSIA
- Seizures
- Severe agitation
- Unconsciousness for a variable period of time
- possible musculoskeletal aches and pains after an event caused by trauma
PREECLAMPSIA
- Nondependent edema (swelling of the hands and face which is present upon arising). Some dependent edema - that is, swelling of the feet and ankles - is considered normal with pregnancy.
- Unintentional weight gain in excess of 2 pounds per week. It may be a very sudden gain over 1 to 2 days.
- Headache which is resistant to treatment with usual pain medications.
- Visual disturbances.
- Epigastric or upper abdominal pain.
Signs and tests
ECLAMPSIA
- Involuntary movements (tonic-clonic seizures) occur.
Written and revised by
Gerald Hurowitz, M.D.
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