It is often prayed that ev
ery pregnant woman remains healthy to reproduce a healthy child as well. But some times, some pregnant women are found encountering convulsions. This is worse in women already with an established case of high blood pressure which of course is often followed by coma. This health challenging situation in pregnancy, posses a serious threat to the health of mother and baby and so must be guided against.
Experts call this condition in which one or more convulsion occur in pregnant women suffering from high blood pressure, which is often followed by coma, eclampsia.
Eclampsia does not just happen, it starts with warning signs called pre-eclampsia. Formerly called toxemia, pre-eclampsia is a condition that develops in pregnancy, usually marked by high blood pressure in women who have not previously experienced high Blood Pressure. Women who find themselves in this condition usually have high level of protein in their urine as well as swollen legs, feet and hands. It is most common in late pregnancy, usually after 20weeks mark.
According to expert reports, pre-eclampsia, when not detected earlier, metamorphoses to full blown eclampsia, .
Regrettably, there seems to be no cure for pre-eclampsia, a fact that tends to get moms-to- be agitated. However, acquainting oneself with the symptoms and by seeking medical advice regularly on prenatal care, one stands a chance to be protected and even in the event of early detection, easy management is assured.
The reason why regular medical attention should be sought is based on grounds of naivity. Preeclampsia is said to be common among first time pregnancies, in pregnant teens, and in women above 40 years, who may not have had any known case of high blood pressure.
Others risk factors include: A history of high blood pressure prior to pregnancy. A history of obesity, having mother or a more serious halth condition that can put victims and their babies at risk sister who had eclampsia etc.
Eclampsia is therefore an acute and life-threatening complication of pregnancy characterized by the appearance of tonic-clonic seizures, usually in a patient who had developed pre-eclampsia.
Eclampsia includes seizures and coma that happen during pregnancy, but are not due to pre-existing or organic brain disorders.
Typically, patients show signs of pregnancy-induced hypertension and proteinuria before the onset of the hallmark of eclampsia; the eclamptic convulsion. Other cerebral signs may precede the convulsion such as nausea, vomiting, headaches, and cortical blindness.
Other organ symptoms may also be noticed, ranging from abdominal pain, liver failure, to pulmonary edema and oliguria. The fetus may already have been compromised by intrauterine growth retardation, and with the toxemic changes during elampsia may suffer fetal distress, placental bleeding and placental abruption may occur.
An eclamptic event could feature four stage. In the state of invasion, facial twitching can be observed around the mouth.
The stage of contraction, tonic contraction or sustained muscular contractions without intervals of relaxation, render the body rigid. This stage may last about 15 to 20 seconds.
The next is the stage of convulsion when involuntary and forceful muscular movements occur, the tongue may be bitten, foam appears at the mouth, the patient stops breathing and becomes cyanotic; this stage lasts about one minute.
The final stage is a more or less prolonged coma. When the patient awakens, she is unlikely to remember the event, in some rare cases, there are no convulsion and the patient falls directly into a coma. Some may experience temporary blindness upon waking from coma.
During a seizure, the fetus may experience bradycardia.
Eclampsia, like pre-eclampsia tends to occur more commonly in first pregnancies and young mothers where it is thought that novel exposure to paternal antigens is involved.
Women with pre-existing vascular diseases, (hypertension, diabetes, and nephropathy) or thrombophilic diseases are at higher risk to develop pre-eclampsia and eclampsia. Having a large placenta (Multiple gestation, hydatidi form mole) also predisposes women to toxemia.
It is important to mention that patients whose mother or sister had the condition are at higher risk. Patients who have experienced eclampsia are at increased risk for preeclampsia / eclampsia in a later pregnancy.
Pulmonary edema is a rather common complication of severe eclampsia affecting approximately 3% of patients. Most cases result in aggressive use of crystalloid solutions for intravascular volume expansion.
While multiple theories have been proposed to explain pre-eclampsia, and eclampsia, it occurs only in the presence of a placenta and is resolved by its removal.
Placental hypoperfusion is a key feature of the process, accompanied by increased sensitivity of the maternal vasculature to pressor agents leading to vasospasm and hypoperfusion of multiple organs.
An activation of the coagulation cascade leads to microthrombi formation and aggravate the perfusion problem. Loss of plasma from the vascular tree with the resulting edema additionally compromises the situation. These events lead to signs and symptoms of toxemia including hypertension, renal, pulmonary and hepatic dysfunction.
Detection and management of pre-eclampsia is critical to reducing the risk of eclampsia. Appropriate management of patents with pre-eclampsia generally involves the use of magnesium sulphate as an agent to prevent convulsions and thus preventing eclampsia
The treatment of eclampsia requires prompt intervention and aims to prevent further convulsion, control the elevated blood pressure and immediately terminate the pregnancy by delivery of the baby if possible.

Sylvia ThankGod-Amadi