Eclampsia is a severe complication of preeclampsia, a pregnancy-related condition characterized by high blood pressure. It’s crucial to understand the difference between preeclampsia and eclampsia, as eclampsia can lead to serious health risks for both the mother and the baby. Preeclampsia is defined as persistent high blood pressure that develops during pregnancy, usually after the 20th week, or in the postpartum period. It is often associated with other complications such as high levels of protein in the urine, decreased blood platelets, kidney or liver problems, fluid in the lungs, and neurological issues like seizures or visual disturbances.
Preeclampsia is diagnosed when a pregnant patient’s blood pressure elevates, typically after the 20th week of pregnancy, and is unique to human pregnancy. Guidelines from the American College of Obstetricians and Gynecologists indicate that a preeclampsia diagnosis doesn’t necessarily require the presence of high levels of protein in the urine (proteinuria). Issues with the kidneys and liver can manifest without proteinuria, and the amount of protein in the urine doesn’t accurately predict the severity of the condition’s progression.
Key symptoms suggestive of preeclampsia include persistent headaches, abdominal pain, shortness of breath or burning sensations behind the sternum, nausea and vomiting, confusion, heightened anxiety, and visual disturbances like light sensitivity, blurred vision, or seeing flashing spots or auras. Preeclampsia and related hypertensive disorders affect 5-8% of all births in the United States.
What is Eclampsia?
Eclampsia takes preeclampsia a step further. Eclampsia is defined as the occurrence of seizures in a woman with preeclampsia. It’s a rare but life-threatening complication that requires immediate medical attention. The seizures are not related to any other pre-existing seizure disorders.
While most women with preeclampsia deliver healthy babies and fully recover, some may experience complications, some of which can be life-threatening to both mother and baby. A woman’s condition can quickly progress to severe preeclampsia, and subsequently, to eclampsia. The rate of preeclampsia in the US has increased by 25% in the last two decades, making it a leading cause of maternal and infant illness and death. This underscores the importance of recognizing and managing preeclampsia effectively to prevent the development of eclampsia.
Symptoms of Eclampsia
The most prominent symptom of eclampsia is seizures. However, other symptoms can precede the seizures, indicating that a woman’s preeclampsia is worsening and she may be at risk. These symptoms include:
- Severe headaches
- Visual disturbances (blurred vision, flashing lights, spots)
- Upper right abdominal pain
- Nausea and vomiting
- Hyperreflexia (overactive reflexes)
- Sudden swelling, especially in the hands and face
It’s important to note that some women with eclampsia may not exhibit any warning signs before experiencing a seizure.
Risk Factors for Eclampsia
Several factors can increase a woman’s risk of developing preeclampsia and, consequently, eclampsia. These include:
- History of preeclampsia: Women who have had preeclampsia in a previous pregnancy are at higher risk.
- Chronic hypertension: Having high blood pressure before pregnancy increases the risk.
- Multiple pregnancy: Carrying twins, triplets, or more increases the risk.
- First pregnancy: Women experiencing their first pregnancy are at higher risk.
- Obesity: Being overweight or obese increases the risk.
- Age: Women younger than 20 or older than 40 are at higher risk.
- Kidney disease: Pre-existing kidney problems increase the risk.
- Diabetes: Both type 1 and type 2 diabetes increase the risk.
- Autoimmune diseases: Conditions like lupus or antiphospholipid syndrome increase the risk.
- In vitro fertilization (IVF): Pregnancies conceived through IVF may have a slightly higher risk.
- Family history: A family history of preeclampsia can increase the risk.
What Does Eclampsia Do?
Eclampsia poses significant risks to both the mother and the baby. During a seizure, the mother may experience:
- Hypoxia: Reduced oxygen supply to the brain and other organs.
- Aspiration: Inhaling stomach contents into the lungs.
- Trauma: Injury from falling or convulsing.
- Stroke: Disruption of blood flow to the brain.
- Brain damage: In severe cases.
- Death: Although rare in developed countries, eclampsia can be fatal.
The baby may experience:
- Reduced oxygen supply: Due to the mother’s seizures.
- Premature birth: Eclampsia often necessitates early delivery.
- Growth restriction: If preeclampsia has affected placental function.
- Stillbirth: In severe cases.
Preeclampsia, if left untreated and progressing to eclampsia, can lead to a rise in blood pressure, potentially causing brain injury. It can also impair kidney and liver function, cause blood clotting problems, pulmonary edema (fluid on the lungs), and seizures. Preeclampsia affects blood flow to the placenta, often resulting in smaller or prematurely born babies.
Prevention and Treatment of Eclampsia
The best way to prevent eclampsia is through careful monitoring and management of preeclampsia. This includes:
- Regular prenatal care: Attending all scheduled appointments allows healthcare providers to monitor blood pressure and other vital signs.
- Blood pressure monitoring: Regularly checking blood pressure at home can help detect early signs of preeclampsia.
- Medications: Antihypertensive drugs can help lower blood pressure.
- Magnesium sulfate: This medication is often given to prevent seizures in women with severe preeclampsia.
- Delivery: The only cure for preeclampsia and eclampsia is delivery of the baby. The timing of delivery depends on the severity of the condition and the gestational age of the baby.
Eclampsia and other hypertensive disorders of pregnancy can be devastating diseases, made worse by delays in diagnosis or management, seriously impacting or even killing both women and their babies before, during, or after birth.
Conclusion
Eclampsia is a serious and life-threatening complication of preeclampsia. Understanding the symptoms, risk factors, and prevention strategies is crucial for ensuring the health and safety of both mother and baby. Early detection and management of preeclampsia are key to preventing the development of eclampsia. If you are pregnant or planning to become pregnant, talk to your healthcare provider about your risk factors for preeclampsia and what you can do to stay healthy. Always seek immediate medical attention if you experience any symptoms of preeclampsia or eclampsia.
For more information about preeclampsia, HELLP syndrome, and related conditions, consult with your healthcare provider. Have questions? Ask your doctor.
