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Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia. [1] Pre-eclampsia is a hypertensive disorder of pregnancy that presents with three main features: new onset of high blood pressure, large amounts of protein in the urine or other organ dysfunction, and edema.
In women with preeclampsia or eclampsia, magnesium sulfate is often prescribed to prevent the occurrence of seizures in the gestational parent. [13] Treatment should be continued from the time of diagnosis to several weeks postpartum given the increased risk of medical complications immediately following delivery of the fetus. [24]
Severe pre-eclampsia involves a BP over 160/110 (with additional signs). It affects 5–8% of pregnancies. [20] Eclampsia – seizures in a pre-eclamptic patient, affect around 1.4% of pregnancies. [21] Gestational hypertension can develop after 20 weeks but has no other symptoms, and later rights itself, but it can develop into pre-eclampsia. [22]
The definitive treatment for pre-eclampsia is the delivery of the baby and placenta, but danger to the mother persists after delivery, and full recovery can take days or weeks. [13] The timing of delivery should balance the desire for optimal outcomes for the baby while reducing risks for the mother. [ 15 ]
Less common presentations include intracranial bleeding, aortic dissection, and pre-eclampsia or eclampsia. [6] Massive, rapid elevations in blood pressure can trigger any of these symptoms, and warrant further work-up by physicians. Physical exam would include measurement of blood pressure in both arms.
When it occurs in pregnancy it is known as eclampsia. [2] The diagnosis requires ruling out other possible causes. [1] The condition is generally treated with medications to relatively rapidly lower the blood pressure. [2] [3] This may be done with labetalol or sodium nitroprusside given by injection into a vein. [2]
Those with PRES with seizures are treated using standard anticonvulsants used in other seizure disorders as there are no specific medications specific to PRES with seizures. [2] [1] However, in those with PRES due to pre-eclampsia or eclampsia, IV magnesium sulfate is the preferred medication for both seizures and hypertension. [2]
As a bronchodilator after beta-agonist and anticholinergic agents have been tried, e.g. in severe exacerbations of asthma. [4]Obstetrics: Magnesium sulfate is used to prevent seizures in women with preeclampsia and eclampsia, and is also used for fetal neuroprotection in preterm deliveries, but has been shown to be an ineffective tocolytic agent.