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ECLAMPSIA

Definition

An attack of convulsions during pregnancy, birth or after birth.

Convulsions, fits or seizures "Eclampsia" is one of the most serious complications of severe preeclampsia. Pre-eclampsia is so named because it was originally identified as a disorder preceding eclampsia. It is now known that eclamptic convulsions is only one of the several potential complications of the disease.

Eclampsia is exceedingly rare and nearly always treatable if appropriate intervention is promptly sought. Eclamptic fits usually occur as a third-stage complication of severe pre-eclampsia. Sometimes they occur of the blue, without any evidence of preceding disturbances.

These seizures can occur at any time in the second half of the pregnanc. In 1974, a case of eclampsia at 16 weeks was reported. At the other extreme, one case was reported as late as 3 weeks after delivery.

These convulsions lead to temporary loss of consciousness and look no different from epileptic fits. The spasms stop the mother from breathing, make her bite her tongue and sometimes cause urinary incontinence.

If fits are not treated, eclamptic seizures can result in coma, brain damage, and possibly maternal or infant death.


Treatment

Magnesium sulfate is the standard course of treatment for eclampsia. It saves mothers lives.


Women on magnesium sulfate compared with mothers on diazepam or phenytoin had

Lower risk of recurrent seizures
Those who had recurrent seizures had fewer fits
Lower risk of maternal death


Babies of mothers on magnesium, compared with babies of mothers on diazepam or phenytoin were

In better condition after delivery
Less likely to need special care
Less likely to be ventilated
Less likely to develop pneumonia
Less likely to need intensive care

Magnesium sulfate should be used by a skilled health care provider with appropriate support facilities as overdoses can and do occur.

Dr Serag Youssif