Eclampsia is a pregnancy complication characterized by high blood pressure and seizurebefore, during, or after labor. This serious condition always preceded by preeclampsia.
Eclampsia is a continuation of preeclampsia. Eclampsia is a rare condition, but must be treated immediately because it can endanger the lives of pregnant women and fetuses.
Symptoms of Eclampsia
The main symptom of eclampsia is seizures before, during, or after delivery. The emergence of eclampsia in pregnant women is always preceded by preeclampsia. Preeclampsia can occur as early as the 20th week of pregnancy.
Preeclampsia will be characterized by blood pressure > 140/90 mm Hg, protein in the urine, and may be accompanied by swelling of the legs. If not treated, preeclampsia can lead to eclampsia.
In some cases, it can happen impending eclampsia marked by:
- Blood pressure is getting higher
- Headaches that are getting worse
- Nausea and vomiting
- Stomach pain, especially in the upper right abdomen
- Swollen hands and feet
- Visual disturbance
- Decreased frequency and amount of urine (oligouria)
- Increased levels of protein in the urine
If it continues, seizures will appear. Seizures from eclampsia can occur before, during, or after delivery.
Eclampsia seizures can occur once or repeatedly. However, there are 2 phases of seizures that can occur when experiencing eclampsia, namely:
- First phaseIn this phase, the seizure will last for 15-20 seconds accompanied by facial twitches, then followed by the appearance of muscle contractions throughout the body.
- Second phaseThe second phase starts in the jaw, then moves to the facial muscles, eyelids, and finally spreads throughout the body for 60 seconds. In the second phase, eclamptic seizures will make muscles contract and relax repeatedly in a fast time.
After the seizures stop, the patient will generally faint. Once conscious, the patient will usually feel very restless and breathe fast because his body lacks oxygen.
When to go to the doctor
Immediately take her to the hospital emergency room if pregnant women experience seizures or symptoms of impending eclampsia as mentioned above. Early treatment is needed to prevent eclampsia and complications.
Get regular check-ups and check-ups with your doctor if you have high blood pressure during pregnancy and if you have been diagnosed with preeclampsia.
Every pregnant woman needs to regularly check her pregnancy to the doctor. Below is a detailed schedule of regular check-ups to the doctor that pregnant women need to do:
- Weeks 4-28: once a month.
- Weeks 28-36: Every 2 weeks.
- Weeks 36-40: once a week.
Causes of Eclampsia
Until now, the cause of preeclampsia and eclampsia is not known with certainty. However, it is suspected that this condition is caused by abnormalities in the function and formation of the placenta. Other factors that are thought to increase the risk of preeclampsia and eclampsia in pregnant women are:
- Have a history of suffering from preeclampsia in a previous pregnancy
- Are having their first pregnancy or are too close between pregnancies (less than 2 years)
- Have a history of chronic hypertension or hypertension in pregnancy
- Pregnant at the age of less than 20 years or more than 35 years
- Have certain conditions and diseases, such as diabetes, kidney disease, sickle cell anemia, obesity, and autoimmune diseases, such as lupus and antiphospholipid syndrome (APS)
- Certain conditions in pregnancy, such as carrying more than one fetus or being pregnant with IVF
Diagnosis of Eclampsia
In diagnosing eclampsia, the doctor will ask the family who brought the pregnant woman to the hospital about the seizures she experienced, including a history of previous pregnancy tests, illnesses, and preeclampsia.
After that, the doctor will conduct a thorough physical examination to ensure that the condition of the pregnant mother and fetus is stable.
To confirm eclampsia and organ damage that has occurred, the following investigations will be carried out:
- Blood test, to find out the overall blood cell count
- Urine test, to check the presence and levels of protein in the urine
- Liver function tests, to detect liver function damage
- Kidney function tests, including urea and creatine, to determine the level of creatine in the kidneys and detect kidney damage
- Ultrasonography (USG), to ensure the condition of the fetus is in good health
Eclampsia Treatment
The only way to treat eclampsia is to deliver the baby in the womb. In pregnant women with preeclampsia who are at risk for developing eclampsia, doctors will generally provide the following treatments:
- Give blood pressure control drugs and vitamin supplements
- Suggest to bed rest at home or in the hospital, sleeping on your left side
- Monitor the condition of the fetus and pregnant women regularly
If a pregnant woman has eclampsia, the doctor will prescribe anticonvulsant drugs. Injection of magnesium sulfate (MgSO4) is the first choice to treat seizures in eclampsia. If the seizures do not improve with magnesium sulfate, your doctor may prescribe benzodiazepines and phenytoin.
Early labor
Pregnant women who suffer from severe preeclampsia or eclampsia will be advised to undergo labor as soon as possible. If the fetus is not yet enough months to be born, the doctor can give injections of corticosteroid drugs to accelerate the maturation of the fetal lungs.
If eclampsia occurs in pregnant women with a gestational age of 30 weeks and under, the doctor will recommend delivery by caesarean section.
Complications of Eclampsia
Without proper treatment, eclampsia can lead to serious complications, including maternal and fetal death. In addition, there are several complications that can occur due to the influence of childbirth or eclampsia treatment, including:
- Side effects of seizures, such as tongue biting, fractures, head injury, aspiration or swallowing of saliva or stomach contents into the respiratory tract
- Central nervous system damage, bleeding in the brain, visual disturbances, even blindness, due to repeated seizures
- Decreased kidney function and acute renal failure
- Liver damage (HELLP syndrome) and circulatory system disorders, such as disseminated intravenous coagulation (DIC)
- Disorders of pregnancy, such as fetal growth restriction, placental abruption, oligohydramnios, or premature birth
- Coronary heart disease and stroke
- Increased risk for developing preeclampsia and eclampsia in subsequent pregnancies
Prevention of Eclampsia
There are no definite steps to prevent preeclampsia and eclampsia. However, the following steps can be taken to reduce the risk of eclampsia in pregnant women:
- Carry out periodic checksPeriodic control during pregnancy needs to be done so that early detection and control of hypertension and preeclampsia can be carried out. By controlling preeclampsia, the risk of eclampsia can be reduced.
- Taking aspirin low doseAspirin in low doses may be given by a doctor according to the condition of the pregnant woman. Giving aspirin can prevent blood clots and blood vessel constriction, so it can prevent the appearance of eclampsia.
- Adopt a healthy lifestyleAdopting a healthy lifestyle, such as maintaining an ideal body weight and quitting smoking, can help reduce the risk of eclampsia when pregnant.
- Taking additional supplementsSupplements with arginine and vitamins are also thought to reduce the risk of eclampsia if taken from the second trimester of pregnancy.