Eclampsia is a complication of pregnancy characterized by high blood pressure and seizures before, during, or after delivery. This emergency condition can occur after the sufferer experiences preeclampsia.

Eclampsia is an advanced condition of preeclampsia. Eclampsia is generally rare, but must be dealt with immediately because it can endanger the life of the pregnant mother and her fetus. This condition generally occurs when the gestational age reaches 20 weeks or more.

Causes of Eclampsia

Until now, the cause of preeclampsia and eclampsia is not known for sure. However, this condition is suspected to be caused by abnormalities in the shape and function of the placenta.

Although the cause is not yet known, there are several factors that are thought to trigger preeclampsia and eclampsia, namely:

  • History of preeclampsia in previous pregnancy
  • Family history of preeclampsia or eclampsia
  • Pregnant at the age of less than 20 years or more than 40 years
  • History of diabetes , kidney disease, sickle cell anemia , obesity , and autoimmune diseases, such as lupus and antiphospholipid syndrome (APS)
  • Twin pregnancy
  • The current pregnancy is the result of the IVF method .

Symptoms of Eclampsia

The main symptoms of eclampsia are cramps that occur before, during, or after childbirth. Eclampsia always occurs after preeclampsia. While preeclampsia itself can arise since the pregnancy reaches the age of 20 weeks.

Preeclampsia is marked by blood pressure that is more than 140/90 mm Hg, the presence of protein in the urine, and can be accompanied by swelling in the limbs. If not treated, preeclampsia can lead to eclampsia.

In some cases, impending eclampsia can occur which is characterized by:

  • Blood pressure is getting higher
  • Severe headache
  • Nausea and vomiting
  • Abdominal pain especially in the upper right part
  • Swelling in hands and feet
  • Visual impairment
  • Decreased frequency and amount of urine (oligouria)
  • Increased levels of protein in the urine

If it continues, the sufferer may experience seizures. These cramps can occur before, during, or after childbirth.

Eclampsia seizures can occur once or repeatedly. However, there are two seizure phases that can occur when experiencing eclampsia, namely:

  • The first
    phase In this phase, the convulsion lasts for 15-20 seconds, which is accompanied by wrinkles on the face, then muscle contractions occur throughout the body.
  • The second
    phase The second phase spasm lasts for 60 seconds, which starts from the jaw, then spreads to the facial muscles, eyelids, and finally spreads to the whole body. In this phase, eclampsia convulsions cause muscles to contract and relax repeatedly in a fast time.

When should you go to the doctor?

Immediately take to the IGD of the nearest hospital if you see a pregnant woman experiencing seizures or symptoms of impending eclampsia as mentioned above. Early treatment is necessary to prevent eclampsia and complications.

Pregnant women who have high blood pressure during pregnancy or have been diagnosed with preeclampsia are advised to check their pregnancy more often .

While in a normal pregnancy, follow the routine check-up schedule to the doctor as follows:

  • 4th to 28th week: 1 time per month
  • 28th to 36th week: every 2 weeks
  • 36th to 40th week: 1 time per week

Diagnosis of Eclampsia

To diagnose eclampsia, the doctor will ask the family who brought the pregnant mother to the hospital about the convulsions experienced, including the history of previous pregnancy examinations, illnesses, and preeclampsia.

After that, the doctor will perform a thorough physical examination to ensure that the condition of the pregnant mother and fetus is stable.

To confirm the diagnosis, the doctor will perform several supporting examinations, which include:

  • Blood test , to check the number of blood platelets
  • Urine test , to find out the level of protein in the urine
  • Liver function test , to check damage in the liver organ
  • Kidney function tests, including urea and creatine, to determine the level of creatine in the kidneys and detect kidney damage
  • Ultrasonography (USG), to check the condition of the fetus

Treatment of eclampsia

The only way to deal with eclampsia is to deliver the baby that was conceived. In pregnant women with preeclampsia who are at risk of experiencing eclampsia, the doctor will perform several treatments, such as:

  • Give blood pressure control drugs and vitamins
  • Recommend bed rest in the hospital or at home under the supervision of a doctor
  • Monitor the condition of the fetus and pregnant mother regularly

In pregnant women who suffer from eclampsia, the doctor will give anticonvulsants. Administering magnesium sulfate (MgSO4) by infusion is the first choice to treat seizures in eclampsia.

However, if the seizures do not improve with magnesium sulfate, the doctor can give benzodiazepines and phenytoin drugs .

Early delivery

Pregnant women with severe preeclampsia or eclampsia will be advised to go into labor as soon as possible. However, if the age of the fetus is not enough months to be born, the doctor will give a corticosteroid injection to accelerate the maturation of the fetus's lungs.

Meanwhile, if eclampsia occurs in pregnant women with a gestational age of 34 weeks or more, the doctor will recommend delivery by caesarean section .

Complications of Eclampsia

Without proper treatment, eclampsia can cause serious complications, including the death of the pregnant mother and fetus. Untreated eclampsia can also cause a number of health complications, such as:

  • Seizure side effects, such as bitten tongue, broken bones, head injuries, and aspiration pneumonia due to stomach contents entering the respiratory tract
  • Damage to the central nervous system, bleeding in the brain, visual impairment, even blindness, due to repeated seizures
  • Organ damage, such as kidney failure  and liver failure
  • HELLP syndrome and disorders of the circulatory system, such as disseminated intravenous coagulation or disseminated intravascular coagulation (DIC)
  • Pregnancy disorders, such as fetal growth retardation, placental abruption , oligohydramnios , or babies born prematurely
  • Coronary heart disease and stroke
  • Risk of preeclampsia and eclampsia in subsequent pregnancies

Prevention of eclampsia

There is no specific way to prevent preeclampsia or eclampsia. However, there are several efforts that mothers-to-be and expectant mothers can make to reduce the risk of eclampsia, namely:

  • Undergoing routine check-ups with the doctor during pregnancy
  • Maintain an ideal weight before and during pregnancy
  • Do not smoke and do not consume alcoholic beverages
  • Consume additional supplements according to the doctor's advice

For pregnant women who are at high risk of preeclampsia, giving aspirin can prevent eclampsia. However, aspirin should be given on the recommendation of a doctor.

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