General Practice 2022

Eclâmpsia in pregnancy: what é, symptoms, causes and treatment

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Eclâmpsia in pregnancy: what é, symptoms, causes and treatment
Eclâmpsia in pregnancy: what é, symptoms, causes and treatment

Eclampsia is a serious complication of pregnancy, characterized by repeated episodes of convulsions, followed by coma, and which can be fatal if not treated immediately. This disease is more common in the last 3 months of pregnancy, however, it can manifest at any time after the 20th week of pregnancy, at birth or even after delivery.

Eclampsia is a serious manifestation of preeclampsia, which causes high blood pressure, greater than 140 x 90 mmHg, presence of protein in the urine and swelling of the body due to fluid retention, but although these diseases are related, not all women with preeclampsia progress to eclampsia. Learn how to identify preeclampsia and when it can become severe.

Symptoms of eclampsia

Symptoms of eclampsia include:

  • Seizures;
  • Intense headache;
  • High blood pressure;
  • Rapid weight gain due to fluid retention;
  • Swelling of hands and feet;
  • Protein loss through urine;
  • Ringing in the ears;
  • Intense bellyache;
  • Vomiting;
  • View changes.

The seizures in eclampsia are usually generalized and last for about 1 minute, and can progress to coma.

Postpartum eclampsia

Eclampsia can also appear after delivery of the baby, especially in women who had preeclampsia during pregnancy, so it is important to keep the evaluation even after delivery, so that any sign of worsening can be identified, and should only be discharged after normalization of pressure and improvement of symptoms.Learn about the main symptoms and how postpartum eclampsia occurs.

Main causes

The causes of eclampsia are related to the implantation and development of blood vessels in the placenta, as the lack of blood supply to the placenta causes it to produce substances that, when falling into the circulation, will alter the blood pressure and cause kidney injuries.

In addition, some factors can increase a woman's risk of developing eclampsia, the main ones being:

  • Pregnancy in women over 40 or under 18;
  • Family history of eclampsia;
  • Twin pregnancy;
  • Women with hypertension;
  • Obesity;
  • Diabetes;
  • Chronic kidney disease;
  • Pregnant women with autoimmune diseases such as lupus.

The way to prevent eclampsia is to control blood pressure during pregnancy and perform the necessary prenatal tests to detect any changes indicative of this disease as early as possible.

How the treatment is done

Eclampsia, unlike common high blood pressure, does not respond to diuretics or a low-s alt diet, so treatment typically includes:

1. Administration of Magnesium Sulfate

Administration of magnesium sulfate into a vein is the most common treatment in cases of eclampsia, which acts by controlling seizures and entering a coma. Treatment should be done after hospital admission and magnesium sulfate should be administered by a he althcare professional directly into the vein.

2. Rest

During the hospital stay, the pregnant woman should rest as much as possible, preferably lying on her left side, in order to improve the blood flow to the baby.

3. Labor Induction

Delivery is the only way to cure eclampsia, however induction can be delayed with medication so that the baby can develop as much as possible.

Thus, during treatment, a clinical examination should be performed daily, every 6 hours to control the evolution of eclampsia, and if there is no improvement, delivery should be induced as soon as possible, in order to resolve the seizures caused by eclampsia.

Although eclampsia usually improves after delivery, complications may arise in the following days, so the woman must be closely monitored and when persistent signs of eclampsia are observed, hospitalization can last from a few days to weeks, depending on the severity of the problem and possible complications.

Possible complications

Eclampsia can cause some complications, especially when not treated quickly as soon as it is identified. One of the main complications is HELLP syndrome, which is characterized by a serious change in blood circulation, in which there is destruction of red blood cells, decrease in platelets and damage to liver cells, causing an increase in liver enzymes and bilirubin in the blood test.Learn more about what HELLP syndrome is and how to treat it.

Other possible complications are decreased blood flow to the brain, causing neurological damage, in addition to fluid retention in the lungs, breathing difficulties, and kidney or liver failure.

In addition, babies can also be affected, and there may be damage to their development or the need to anticipate delivery. In some cases, the baby may not be fully developed, which can lead to problems, such as breathing difficulties, requiring follow-up by a neonatologist and, in some cases, hospitalization in the ICU to ensure better care.

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