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Eclampsia

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Eclampsia, considered a complication of severe pre-eclampsia, is commonly defined as new onset of seizures and/or unexplained coma during pregnancy or postpartum in a woman with signs or symptoms of pre-eclampsia.

Eclampsia is rarely seen in developed countries. It has an incidence of 2.1 per 10,000 maternities in the UK. Eclampsia is associated with increased risks of maternal and perinatal morbidity and mortality. Significant maternal life-threatening complications as a result of eclampsia include:

  • Pulmonary oedema
  • Renal and hepatic failure
  • Placental abruption and haemorrhage
  • Disseminated intravascular coagulation (DIC)
  • HELLP syndrome (See also,HELLP)
  • Cerebral haemorrhage

Hypertension is nor necessarily a precursor to the onset of eclampsia but will almost always be evident following a seizure. The aims of immediate care are to preserve the mother's life: summon medical aid, clear and monitor the mother's airway, administer oxygen, prevent injury. Intravenous anticonvulsant and antihypertensive therapies will be administered according to protocol, and it is usual to expedite delivery of the baby, usually via caesarean section.

 

Further reading

Michael G Ross (2015). Eclampsia. Medscape. http://emedicine.medscape.com/article/253960-overview

National Institute for Health and Care Excellence (NICE) (2016). NICE Pathways. Severe hypertension, severe pre-eclampsia and eclampsia in critical care. Available at: http://pathways.nice.org.uk/pathways/hypertension-in-pregnancy/severe-hypertension-severe-pre-eclampsia-and-eclampsia-in-critical-care

NICE Clinical Knowledge Summaries (2015). Hypertension in pregnancy. Available at: http://cks.nice.org.uk/hypertension-in-pregnancy

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