Eclampsia, Causes, Diagnosis, Treatment, Prevention, Complications

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Eclampsia is a pregnancy complication characterized by high blood pressure and seizures before, during or after delivery. This emergency condition can occur after the sufferer has preeclampsia.

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Eclampsia, Causes, Diagnosis, Treatment, Prevention, Complications


Eclampsia is an advanced condition of preeclampsia. Eclampsia is generally rare, but must be treated immediately because it can endanger the life of pregnant women and their fetuses. This condition generally occurs when the gestational age reaches 20 weeks or more.

Causes of Eclampsia


Until now, the causes of preeclampsia and eclampsia are not known with certainty. However, this condition is thought to be caused by abnormalities in the shape and function of the placenta.

Although the cause is unknown, there are several factors that are thought to trigger preeclampsia and eclampsia, namely:

  • History of preeclampsia in a previous pregnancy
  • Family history of preeclampsia or eclampsia
  • Pregnant at the age of less than 20 years or more than 40 years
  • History of diabetes, kidney disease, sickle cell anemia, obesity, and autoimmune diseases, such as lupus and antiphospholipid syndrome (APS)
  • Twin pregnancy
  • The pregnancy being undertaken is the result of IVF method


Symptoms of Eclampsia


The main symptom of eclampsia are seizures that occur before, during, or after labour. Eclampsia always follows preeclampsia. Meanwhile, preeclampsia itself can arise from the age of 20 weeks of pregnancy.

Preeclampsia is characterized by blood pressure that is more than 140/90 mm Hg, the presence of protein in the urine, and can be accompanied by swelling in the legs. If not treated, preeclampsia can lead to eclampsia.

In some cases, impending eclampsia can occur which is characterized by:

  • Blood pressure is getting higher
  • Severe headache
  • Nausea and vomiting
  • Abdominal pain, especially in the upper right
  • Swelling in hands and feet
  • Impaired vision
  • Decreased frequency and amount of urine (oliguria)
  • Increased levels of protein in the urine


If it continues, sufferers can experience seizures. These seizures can occur before, during, or after labour.

Eclampsia seizures can occur once or repeatedly. However, there are two phases of seizures that can occur when experiencing eclampsia, namely:

  • First phase

In this phase, the spasm lasts 15–20 seconds, which is accompanied by twitching of the face, then muscle contractions occur throughout the body.

  • Second phase

The second phase of seizures lasts for 60 seconds, starting in the jaw, then radiating to the facial muscles, eyelids, and finally spreading to the rest of the body. In this phase, eclampsia seizures cause the muscles to contract and relax repeatedly in a fast time.

When to see a doctor

Immediately take it to the emergency room at the nearest hospital if you see a pregnant woman having seizures or symptoms of impending eclampsia as mentioned above. Early treatment is needed to prevent eclampsia and complications.

Pregnant women who have high blood pressure during pregnancy or have been diagnosed with preeclampsia are advised to have their pregnancies checked more often.

While in a normal pregnancy, follow the routine check-up schedule to the doctor as follows:

  • Week 4 to 28: 1 month
  • 28th to 36th week: once every 2 weeks
  • Week 36 to 40: 1 week


Diagnosis of Eclampsia


To diagnose eclampsia, the doctor will ask the family who brought the pregnant woman to the hospital about the seizures she is experiencing, including a history of previous prenatal checks, illnesses, and preeclampsia.

After that, the doctor will carry out a thorough physical examination to determine whether the condition of the pregnant woman and fetus is stable.

To make a diagnosis, the doctor will carry out several supporting examinations, which include:

  • Blood test, to check the number of blood platelets
  • Urine test, to determine the level of protein in the urine
  • Liver function tests, to check for damage to the liver
  • Kidney function tests, including urea and creatine, to measure the level of creatine in the kidneys and detect kidney damage
  • Ultrasonography (USG), to check the condition of the fetus


Eclampsia Treatment


The only way to treat eclampsia is to deliver the baby. In pregnant women with preeclampsia who are at risk of experiencing eclampsia, doctors will carry out several treatments, such as:

  • Provide blood pressure control drugs and vitamins
  • Suggest bed rest in the hospital or at home under the supervision of a doctor
  • Monitor the condition of the fetus and pregnant women regularly


In pregnant women who experience eclampsia, doctors will give anti-seizure drugs. Infusion of magnesium sulfate (MgSO4) is the first choice for treating seizures in eclampsia.

However, if the seizures do not improve with magnesium sulfate, the doctor can give benzodiazepines and phenytoin.

Early labour


Pregnant women who experience severe preeclampsia or eclampsia will be advised to undergo labor as soon as possible. However, if the fetus is not old enough to be born, the doctor will give corticosteroid injections to accelerate the maturation of the fetal lungs.

Meanwhile, if eclampsia occurs in pregnant women with a gestational age of 34 weeks or more, the doctor will recommend delivery by caesarean section.

Eclampsia complications


Without proper treatment, eclampsia can cause serious complications, including the death of the pregnant woman and fetus. Untreated eclampsia can also cause a number of health complications, such as:

  • Side effects of seizures, such as biting the tongue, broken bones, head injuries, and aspiration pneumonia due to gastric contents entering the respiratory tract
  • Damage to the central nervous system, bleeding in the brain, impaired vision, even blindness, due to repeated seizures
  • Organ damage, such as kidney failure and liver failure
  • HELLP syndrome and disorders of the circulatory system, such as disseminated intravascular coagulation (DIC)
  • Pregnancy disorders, for example fetal growth retardation, placental abruption, oligohydramnios, or babies born prematurely
  • Coronary heart disease and stroke
  • The risk of experiencing preeclampsia and eclampsia in subsequent pregnancies


Eclampsia Prevention


There is no specific way to prevent preeclampsia or eclampsia. However, there are several efforts that can be made by expectant mothers and pregnant women to reduce the risk of eclampsia, namely:

  • Undergo routine control to the doctor during pregnancy
  • Maintain ideal body weight before and during pregnancy
  • Do not smoke and do not consume alcoholic beverages
  • Take additional supplements according to doctor's advice


For pregnant women who are at high risk of experiencing preeclampsia, giving aspirin can prevent eclampsia. However, the administration of aspirin must be on the advice of a doctor.

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