Eclampsia is a most severe degree of a disease which in its mild form is called pre-eclampsia. Any woman who is suffering from preeclampsia runs a risk of developing eclampsia which is characterized by the occurrence of convulsions or fits. The fits last approximately one minute and are followed by a period of unconsciousness. Eclampsia occurs in late pregnancy or it may begin during labour or even after delivery. When a convulsion happens all the signs and symptoms of pre-eclampsia are present:
1 Raised blood pressure.
2 Generalized swelling or oedema.
3 Protein in the urine.
(4 Abnormally high weight gain.)
The woman also suffers one or more of the following symptoms:
Severe headache occurring characteristically over the front part of the head above the eyes and associated with an abnormal rise in blood pressure. It is persistent and is not relieved by aspirin or other normal ‘headache tablets’.
Visual disturbances. These may be flashes of light before the eyes, coloured moving spots or blurring of vision and occasionally complete although temporary blindness.
Irritability. The woman is irritable, apprehensive and unable to tolerate noise or other mild disturbances.
Abdominal pain. Pain in the upper abdomen which may be mistaken for indigestion is usually severe, persistent and may be accompanied by actual vomiting which foils to relieve it.
The best treatment for eclampsia is its prevention. Eclampsia is one of the most dangerous complications of pregnancy and even in the very best hands it may cause a patient’s death. Even today approximately 1 in 20 women who develop eclampsia do not survive. The risk to the baby is even greater and approximately 1 in 5 babies fail to live. These figures show the reality of the danger of eclampsia which in the majority of instances should never happen. An isolated case is however bound to occur even with the most stringent antenatal care because the mother’s blood pressure rises suddenly and without warning.
Prevention is the keynote and one of the many advantages of careful supervision during pregnancy has been the early recognition and adequate treatment of pre-eclampsia which in turn has virtually eliminated eclampsia itself in Great Britain.
At the onset of eclamptic fits the patient is heavily sedated to prevent their recurrence. Expert nursing care in hospital is absolutely essential. If fits occur at home the doctor must be notified immediately and he will administer an appropriate sedative and arrange for the woman to be transferred to hospital. If labour starts spontaneously it may progress rapidly and easily while the fits are controlled by sedatives. If it does not, then, depending on the woman’s condition, it may be necessary to induce labour or perform Caesarean section.