Eclampsia is a toxic condition that is defined by convulsions and possibly coma taking place during or instantly after pregnancy. It is a serious pregnancy complication, usually, occurring after the early stages of pre-eclampsia, although sometimes the pre-eclamptic symptoms are not recognizable. The convulsions of eclampsia happen before, during, or even after labor, even if cases of this complication have been recorded after just 20 weeks of pregnancy.
Signs and Symptoms of Eclampsia
Most of the cases of Eclampsia are diagnosed by proteinuria and pregnancy-induced hypertension. But the most obvious and true sign if eclampsia is an eclamptic convulsion, having four stages. Patients suffering from edema and oliguria, might develop pulmonary edema or renal failure. The four stages are: premonitory stage, tonic stage, clonic stage, and comatose stage.
Premonitory stage: This is the stage that usually remains unrecognized unless it is constantly monitored. Here, the pregnant woman rolls her eyes while her hand and facial muscles undergo slight twitch.
Tonic Stage: Just after the first stage, the twitching gets replaced by clenching. Sometimes, the pregnant woman may even bite her tongue while clenching her teeth, and the legs and arms turn rigid. The respiratory muscles undergo spasm, thus causing the woman to stop respiration. This stage of pre-eclampsia continues for nearly 30 seconds.
Clonic Stage: In this stage, the spasm stops and the muscles start jerking violently. Foaming, slightly bloodied saliva comes out of the patient’s mouth and can sometimes even be inhaled. For nearly two minutes the convulsion stops, and leads to a stage of temporary unconsciousness.
Comatose Stage: In this stage, the pregnant woman falls deeply unconscious and breathes noisily. This condition can last for a few minutes or for hours.
- Treatment of Eclampsia
- The eclampsia seizures treatment consists of:
- Controlling the blood pressure
- Prevention of convulsion
- Delivery of fetus
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The blood pressure of the patient can be controlled by giving hydralazine 5mg IV for every 5 minutes until the blood pressure gets lowered. It can also be repeated as required or can give hydralazine 12.5mg IM for every 2 hours according to the needs.
Eclamptic convulsion is usually prevented by using magnesium sulfate along with a loading of magnesium sulfate 20% solution, 4g IV for every 5 minutes. After this, maintain with 1g magnesium sulfate of 10% solution in 1000ml fluid drip of 1g per hour.
The delivery of the birth must take place only when the condition of the woman gets stabilized and should occur irrespective of the gestational age.
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