Eclampsia and Preeclampsia

What Is It?

Preeclampsia is a condition that occurs only during pregnancy, after the 20th week. A woman with preeclampsia develops high blood pressure and protein in the urine, and is often noted to have swelling (edema) of the legs, hands, face or entire body. Eclampsia is a complication of preeclampsia marked by seizures or coma. The condition affects both mother and fetus. In preeclampsia, the mother's blood vessels constrict (become narrower). This decreases the blood supply to the fetus and placenta (afterbirth), the woman's kidneys, liver, eyes, brain and other organs.

Preeclampsia and eclampsia are leading causes of illness and death for mothers and newborns. Preeclampsia occurs in approximately 5 percent to 8 percent of pregnant women in the United States. Eclampsia occurs in one of every 200 women with preeclampsia, and is often fatal if not treated.

The cause of preeclampsia remains unknown although many theories have been suggested. However, the following conditions increase the chance that a woman will develop preeclampsia and eclampsia:

• Chronic (long-lasting) high blood pressure
• Obesity
• Diabetes
• Kidney disease
• Age under 15 or over 35 years old
• First pregnancy
• Multiple gestations (twins, triplets or greater)
• Lupus or other collagen vascular disease
• African-American ethnicity
• Having a sister, mother or daughter who has had preeclampsia

Symptoms

Mild preeclampsia — A woman with mild preeclampsia may not notice any symptoms, or may have only mild swelling of the hands or feet. However, most pregnant women have some degree of swelling, so not all swelling indicates preeclampsia.

Severe preeclampsia — Symptoms can include:

• Headache
• Visual changes
• Nausea and abdominal pain, usually in the upper abdomen
• Difficulty breathing
• Pelvic pain
• Bleeding, such as from the gums or the vagina, or blood in the urine

Eclampsia — Eclampsia causes seizures, which consist of loss of consciousness with jerking movements of the arms and legs and possible loss of control of bladder or bowels.

Diagnosis

Because preeclampsia doesn't always cause noticeable symptoms, it is crucial that all pregnant women see a health-care provider regularly during pregnancy for prenatal care. This gives you the best chance of having preeclampsia diagnosed and treated before it becomes severe. Your doctor or midwife will measure your blood pressure and test your urine for protein at each prenatal visit because abnormal results are the earliest, most common signs of preeclampsia.