What is Eclampsia?
Pre-eclampsia is a disorder that pregnant women experience in which blood pressure of the patient increases a lot and urine contains protein. There may also be some other organ dysfunction as well. Eclampsia is basically the most critical condition of pre-eclampsia where the women start having seizures. These seizures caused in eclampsia usually last about a minute and the person experiences confusion after the episode is over and may even go into a coma. Eclampsia is included under the hypertensive disorders of pregnancy.
Usually affecting women in their second half of the pregnancy, eclampsia may occur even after delivery. Eclampsia seizures also include staring episodes and a marked decrease in alertness along with violent convulsions. Eclampsia is very rare and only affects about 0.5% women suffering from pre-eclampsia.
Symptoms of Eclampsia
Since eclampsia is related with pre-eclampsia, it may have some symptoms of the latter as well. Some of these symptoms include-
- Women typically experience hypertension that is an increase in the blood pressure before the onset of convulsions that signals eclampsia.
- Proteinuria is also a main symptom of eclampsia which basically means presence of large amount of proteins in urine.
- Convulsions or seizure is actually the symptom that denotes the progression of eclampsia from pre-eclampsia.
- These eclampsia convulsions affect the brain mostly cerebral region therefore other symptoms may also show themselves after the ordeal is over. These include nausea, vomiting, headaches and even cortical blindness due to brain damage.
- Multi-organ failure may also occur after the seizure caused by eclampsia which may result into new symptoms such pain in the abdomen, jaundice, decreased urination and panting or shortness of breath.
- Eclampsia symptoms may also include retardation of intrauterine growth of the fetus which means retarded growth of the baby in the womb.
- Convulsions in the mother caused by eclampsia can also lead to fetal distress and a decreased heart rate of the fetus as well, a condition known as bradycardia.
- A quite common complication of eclampsia is pulmonary edema which means fluid accumulation in the lungs. Approximately 3% people with eclampsia suffer from this symptom.
- Placental abruption which means detaching of placenta and placental bleeding may also occur due to eclampsia.
- Agitation, muscle pains and headaches are also some of the symptoms of eclampsia.
Causes of Eclampsia
Eclampsia usually develops from pre-eclampsia and the underlying cause for pre-eclampsia is not accurately known as yet. Increased blood pressure and the presence of proteins in urine (proteinuria) are the main signs of pre-eclampsia which may affect the brain if it gets worse. The affected brain causes convulsions resulting into eclampsia. These two causes are explained here:
High Blood Pressure
If the blood pressure increases a lot during pregnancy, it puts pressure on the walls of the arteries causing them to get damaged. This damaging of arteries as well as adjoining blood vessels may prevent blood flow which may accumulate in the region. This may cause swelling in the brain and may also do so in the growing baby as well, causing the onset of convulsions and seizures known as eclampsia.
Glomerulus is an apparatus present in the kidney whose function is to filter waste from blood and generate urine. However the blood cells and proteins are not excreted through them and are retained by the body. When these filters get damaged, proteins are secreted out with urine resulting into proteinuria which may cause eclampsia. For this purpose urine of the pregnant women are tested for the presence of proteins regularly so as to prevent eclampsia in them before it is too late.
Risk Factors of Eclampsia
Risk factors of eclampsia and the people who are at the most risk of getting the problem of eclampsia include:
- Those who are suffering from pre-eclampsia are prime candidates for getting eclampsia as well. So it is better to manage it before it gets more problematic.
- Young mothers who are less than 20 years of age and women getting pregnant for the first time are more prone to get eclampsia. It is believed that this is because of their novel exposure to paternal antigens.
- Hypertension is another risk factor of eclampsia.
- Women suffering from kidney disease or diabetes are at higher risk of getting eclampsia.
- Having a large placenta is also a risk factor of eclampsia. This may happen because of multiple gestation or some other reason.
- Women with family history of the condition are at a higher risk of getting eclampsia. If they have a sister or mother who already had eclampsia then odds are that they may get it too.
- Similarly women who already suffered from eclampsia or pre-eclampsia in a pregnancy have a higher risk of getting it again when and if they get pregnant again.
- Also women who are above 35 years of age are also at more risk of getting eclampsia.
- If a woman is pregnant with twins, she has higher chances of getting eclampsia and therefore is at higher risk.
- A history of poor diet and nutrition can also be a risk factor for eclampsia.
Diagnosis of Eclampsia
If you are having seizures or any other symptoms, the doctor will prescribe some tests to determine why you are suffering from these symptoms and to diagnose the problem and eliminate the possibility of eclampsia. The doctor may also ask you to get those same tests if you already suffered from eclampsia or pre-eclampsia or if you have a family history of it.
Some of these diagnostic measures are given below-
There are many blood tests that a doctor can ask his patients to get but the most common one that doctors prescribe is hematocrit which measures the number of red blood cells as well as platelets. Platelets help the doctors to determine whether the blood is clotting properly or not. They help in determining whether the woman is suffering from pre-eclampsia or eclampsia and also help in evaluating kidney and liver functions as well.
An excess of creatinine in the blood may means pre-eclampsia or eclampsia even though it may be due to some other reason. Creatinine is a waste product of muscles which gets excreted out of the body through kidneys. If the kidneys get damaged, creatinine starts building up in the body due to its insufficient excretion which may indicate eclampsia.
The doctor may also ask you to get your urine tested to see whether it contains proteins or not. This may help the doctor in evaluating the presence or risk of eclampsia.
Treatments for Eclampsia
The only permanent treatment for eclampsia is delivering the baby even though doctors may prescribe certain medications if you are suffering from pre-eclampsia to keep it from turning into eclampsia. The doctor may make the decision of delivering your baby early if you develop eclampsia. This decision usually depends on the health and growth of the baby, how far along you are in your pregnancy and how severe is your eclampsia. It basically comes down to these two situations:
If The Baby Has Matured
If you are close to your term that is 37th week or after and your baby has matured enough, the doctor may decide to perform a C-section or to induce labor (whichever is preferable) and deliver your baby. This will cure your eclampsia effectively.
If The Baby Is Not Mature Enough
If your baby is not matured enough to deliver safely, your doctor may prescribe some medications until it has grown enough to be safely delivered if you are suffering from eclampsia. The more mature your baby and closer to your due date, the safer it is for both you and your baby.
If this is the case, then some measures need to be taken, which are as follows:
If the pregnant women has eclampsia and is suffering from convulsions and seizures, she may be given anticonvulsants to cure her of that. Doctors may also prescribe her some low dosages aspirin. Other than that doctors may also prescribe some blood pressure lowering medications to control hypertension.
There are some things that you may also do, if you are suffering from eclampsia to get yourself out of this bind. They are as follows:
- Eat a healthy and balanced diet with all the nutrients that your body requires.
- You need to be proactive and have frequent check-ups as well as monitoring of the baby.
- Get plenty of rest.
- Avoid stress, tension and anxiety.
- Take all your medications exactly as the doctor asked.
- If you feel any discomfort or change in your condition, contact your doctor as soon as possible.
Can Your Baby Get Affected Because of Eclampsia?
If eclampsia is properly managed, the effects to your child should be very little but eclampsia does affect placenta reducing blood flow to it which may result into decreased oxygen, blood and nutrient supply to the fetus. This may cause suffocation, placental abruption and in some cases even stillbirth even though it is very rare. Placental abruption which refers to detachment of placenta from the uterus is a condition which, if does occur, leaves doctors no choice but to perform a caesarean operation in emergency to save the baby’s life. These problem caused by eclampsia may also cause your baby to be born with low weight and various health issues.
Even though the issues related with eclampsia get resolved once the baby is born, there is still an increased risk of the mother suffering from both eclampsia and pre-eclampsia in the subsequent pregnancies.
But if you talk to your doctor and inform him/her about your symptoms and/or history of eclampsia in yourself or your family, it can be better managed reducing the risks to some extent.