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Eclampsia

Definition

Eclampsia is the new onset of or coma in a pregnant woman with preeclampsia. These seizures are not related to an existing brain condition.

Causes

The exact cause of eclampsia is not known. Factors that may play a role include:

  • Blood vessel problems
  • Brain and nervous system (neurological) factors
  • Diet
  • Genes

    • Eclampsia follows a condition called . This is a complication of pregnancy in which a woman has high blood pressure and other findings.

    Most women with preeclampsia do not go on to have seizures. It is hard to predict which women will. Women at high risk of seizures often have severe preeclampsia with findings such as:

  • Abnormal blood tests
  • Headaches
  • Very high blood pressure
  • Vision changes
  • Abdominal pain

    • Your chances of getting preeclampsia increase when:

  • You are 35 or older.
  • You are African American.
  • This is your first pregnancy.
  • You have , high blood pressure, or kidney disease.
  • You are having more than 1 baby (such as twins or triplets).
  • You are a teen.
  • You are obese.
  • You have a family history of preeclampsia.
  • You have autoimmune disorders.
  • You have undergone in vitro fertilization.

    • Symptoms

    Symptoms of eclampsia include:

  • Seizures
  • Severe agitation
  • Unconsciousness

    • Most women will have these symptoms of preeclampsia before the seizure:

  • Headaches
  • Nausea and vomiting
  • Stomach pain
  • Swelling of the hands and face
  • Vision problems, such as loss of vision, blurred vision, double vision, or missing areas in the visual field

    • Exams and Tests

    The health care provider will do a physical exam to look for causes of seizures. Your blood pressure and breathing rate will be checked regularly.

    Blood and urine tests may be done to check:

  • Blood clotting factors
  • Hematocrit
  • Protein in the urine
  • Hemoglobin level

    • Treatment

    The main treatment to prevent severe preeclampsia from progressing to eclampsia is giving birth to the baby. Letting the pregnancy go on can be dangerous for you and the baby.

    You may be given medicine to prevent seizures. These medicines are called anticonvulsants.

    Your provider may give medicine to lower high blood pressure. If your blood pressure stays high, delivery may be needed, even if it is before the baby is due.

    Possible Complications

    Women with eclampsia or preeclampsia have a higher risk for:

  • Separation of the placenta ()
  • Premature delivery that leads to complications in the baby
  • Blood clotting problems
  • Stroke
  • Infant death

    • When to Contact a Medical Professional

    Contact your provider or go to the emergency room if you have any symptoms of eclampsia or preeclampsia. Emergency symptoms include seizures or decreased alertness.

    Seek medical care right away if you have any of the following:

  • Bright red vaginal bleeding
  • Little or no movement in the baby
  • Severe headache
  • Severe pain in the upper right abdominal area
  • Vision loss
  • Nausea or vomiting

    • Prevention

    Getting medical care during your entire pregnancy is important in preventing complications. This allows problems such as preeclampsia to be detected and treated early.

    Getting treatment for preeclampsia may prevent eclampsia.

    References

    American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-1131. PMID: 24150027 pubmed.ncbi.nlm.nih.gov/24150027/.

    Harper LM, Tita A, Karumanchi SA. Pregnancy-related hypertension. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 48.

    Henn MC, Lall MD. Complications of pregnancy. In: Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 173.

    Sibai BM. Preeclampsia and hypertensive disorders. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 38.

    Schedule An Appointment

    Contact Atlanta Obsetrics and Gynaecology at The Womens Center Millennium Hospital - 404-ATL-BABY

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    Review Date: 1/10/2022

    Reviewed By: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.