Eclampsia – causes, symptoms & therapy

Eclampsia is a pregnancy disorder in which the pregnant woman suffers seizures similar to epileptic seizures. Eclampsia develops from preeclampsia, which occurs in 5% of all pregnancies.

This preliminary stage of eclampsia is mainly characterized by increased blood pressure in the pregnant woman and an increased protein content in the urine when the kidneys excrete too much protein ( proteinuria ). Eclampsia occurs from the 20th week of pregnancy and usually lasts up to 6 weeks after birth. No damage is left to the mother.

causes

In pregnant women who develop eclampsia, the placenta does not receive enough blood because the blood vessels in it do not grow large enough. However, good blood circulation in the placenta is essential for supplying the child with nutrients and oxygen. Therefore, the mother’s blood pressure is increased to improve the child’s care.The placenta also sends out signal substances that lead to kidney changes and protein excretion. The exact causes of the disrupted development of the blood vessels in the placenta have not yet been clarified.

However, some factors are known to increase the risk of developing eclampsia. For example, eclampsia occurs more frequently in primiparous women, in young pregnant women (under 20 years of age), in pregnant women who are diabetic , overweight or have a tendency to develop thrombosis . Daughters of women with eclampsia also have an increased risk of developing eclampsia during pregnancy.

When to the doctor?

Atypical forms of development and progression of eclampsia are not uncommon. Therefore, any small symptom, no matter how insignificant, can be the harbinger of full-blown eclampsia. If you experience any of the symptoms that may indicate eclampsia, it makes sense to inform the responsible doctor when you have the opportunity.

However, if there is high blood pressure, pre-eclampsia or other risk factors, such as the age of the pregnant woman (over 35 years), severe obesity or a family history of eclampsia, headaches in the forehead and temples, visual disturbances and edema should occur hands and face lead to a timely doctor’s visit. Difficulty breathing that occurs together with high blood pressure can indicate a possible heart-lung problem and should be treated quickly by a doctor. Likewise, the possible harbingers of a seizure, which include confusion in connection with visual disturbances and inner restlessness, must be examined by a doctor.

Nausea, a severe feeling of illness, upper abdominal discomfort , right abdominal pain, and diarrhea can mean the liver is also affected. In this case, a doctor or emergency doctor should be notified immediately, since these symptoms can develop into a dramatic course of the disease in a very short time. If seizures occur, it is absolutely necessary to call an emergency doctor!

symptoms and course

Typical symptoms of eclampsia:

• high blood pressure

• Payment

• visual disturbances

• double vision

• headache

• nausea

• stomach pain

The most important symptoms of preeclampsia and thus a warning sign of eclampsia are high blood pressure and proteinuria in the pregnant woman. However, the pregnant woman does not notice any of this. In addition, there is water retention (edema) in atypical areas such as the hands and face (edema in the legs is typical during pregnancy). Sudden weight gain can also be an indication of edema. Those affected also often complain of visual disturbances, double vision, headaches and nausea.

If the onset of preeclampsia is rapid, the liver may also be involved. Then the patients express severe right-sided abdominal pain and nausea. The health of the mother can thus deteriorate dramatically. After signs of pre-eclampsia or out of complete subjective well-being, those affected can develop the full picture of eclampsia with seizures and even coma. Complications such as growth disorders, placenta detachment and, in the worst case, the death of the unborn child are threatened for the child.

Diagnose

In order to detect preeclampsia early and to prevent eclampsia, blood pressure must be measured at every prenatal check-up. In addition, the urine must be tested for its protein content. If preeclampsia is suspected, further blood pressure measurements must be carried out. Blood is also taken to determine kidney values, liver values , blood platelet count and blood clotting factors. Blood flow to the placenta can be determined with a color-coded ultrasound , the condition of the child is monitored with ultrasound.

complications

Eclampsia is a very serious disease. In the worst case, this can lead to a coma in the pregnant woman or to death. In most cases, this leads to a greatly increased blood pressure in the patient. This can continue to lead to heart problems and thus severely limit the quality of life of those affected. It is not uncommon for patients to suffer from significant visual disturbances and double vision or blurred vision. Headaches and severe abdominal pain are also common symptoms of eclampsia.

Those affected gain a lot of weight and excrete a large amount of protein in their urine. If the eclampsia is not treated, the child will suffer from various limitations and disorders after birth. It is not uncommon for growth disorders or developmental disorders to occur. Eclampsia is always treated by prematurely terminating the pregnancy. Premature delivery is usually always associated with risks and complications, so that a positive course of the disease cannot be guaranteed. In some cases, this can even lead to the death of the patient. Furthermore, most patients and their partners suffer from severe psychological problems.

treatment and therapy

Because eclampsia is caused by pregnancy, the only way to treat it is by terminating the pregnancy. The time of delivery varies depending on the health of the mother and the week of pregnancy.

In the case of mild preeclampsia, the pregnant woman is admitted to the hospital, receives protein-rich food and has to lie on her left side in bed. The condition of mother and child is regularly monitored.

If eclampsia occurs up to 34 weeks gestation, the mother is given cortisol to speed up the maturation of the child’s lungs. After completing the 36th week of pregnancy, the birth is induced.For severe preeclampsia, the pregnant woman is given magnesium sulfate and sedatives to prevent eclampsia with seizures. Drugs are also used to lower blood pressure. If the condition of the mother allows it, an attempt is made to delay the birth until the 36th week of pregnancy.

In eclampsia, the seizure is stopped with sedatives and labor is initiated. The mother must be closely monitored after the birth as seizures can still occur after the birth. With appropriate treatment of the eclampsia, however, the mother does not suffer any consequential damage, but there is an increased risk of eclampsia with further pregnancies.

prevention

Since no exact causes are known, it is important to recognize preeclampsia early and treat the pregnant woman accordingly. This is the only way to avoid life-threatening complications for the mother and consequential damage for the child. Accordingly, the best prevention is compliance with the prenatal check-ups at the gynecologist.