Eclampsia

Eclampsia is a dangerous form of gestosis in late pregnancy. The manifestation of eclampsia consists in convulsive syndrome, loss of consciousness, dysfunction of vital body systems, in some cases a stroke occurs. Eclampsia of pregnant women can have the most critical consequences for both the expectant mother and the fetus inside the womb. To diagnose the disease, a complete history of the woman is required, as well as an assessment of the risk of possible eclampsia in the future. Be sure to prescribe laboratory tests. Treatment of eclampsia consists in creating an atmosphere of peace and tranquility for the inner state of the patient. Treatment of external signs of eclampsia (seizures, cerebral edema, dropsy) is aimed at regression of symptoms with minimal risks to the fetus.

The content of the article:
What is eclampsia?
Causes and forms of eclampsia
Symptoms of eclampsia
Diagnosis of eclampsia
Treatment of eclampsia
Prevention of eclampsia
Eclampsia
What is eclampsia?
Eclampsia is a critical stage of the manifestation of gestosis. Gestosis is a late toxicosis that develops in a pregnant woman in the second or third trimester. The rapidly emerging signs of eclampsia are as follows:

the occurrence of seizures;
brain edema;
comatose state: in a matter of minutes they reach the maximum limit.
Quite rarely, however, cases have been recorded in gynecology when eclampsia has no external signs of development, with the exception of only one — a cerebral hemorrhage followed by a possible coma.

Causes and forms of eclampsia
The main factors provoking the development of eclampsia are:

changing the potassium-calcium balance;
regression of blood microcirculation;
vasoconstriction with the help of special medications;
abnormal cell development due to hypertension.
Signs of eclampsia may appear due to a woman’s failure to comply with pregnancy recommendations. The risk of having the disease increases if:

a woman over 35 years old;
the patient has a history of past recorded seizures, loss of consciousness;
there is no balance of daily loads and rest;
the pregnant woman does not follow the recommendations for the use of the amount of liquid / food.
Eclampsia of pregnant women may also be present due to the presence of internal health problems: diabetes mellitus, obesity, hypertension, gastritis, colitis, lupus, trophoblastic disease. The risk of eclampsia increases with multiple pregnancies, polyhydramnios, the presence of toxicosis in any form in past pregnancies.

The forms of eclampsia are established clinically , depending on the main sign:

renal — the main manifestation: urinary deficiency in the kidneys;
hepatic — dysfunction of the metabolic process in the body with a general severe clinical disorder;
brain — with a further possibility of stroke;
comatose is the most dangerous form of eclampsia. The comatose form develops asymptomatically. Within a few minutes, a brain hemorrhage occurs, after which a coma stage occurs.
Symptoms of eclampsia
The symptoms of the disease are accompanied by the presence of the preeclampsia process:

nausea;
vomiting;
violation of coordination;
visual impairment;
severe headache;
in some cases — numbness of the limbs;
convulsive tension.
From a clinical point of view, eclampsia of pregnant women looks like this: instant loss of consciousness with convulsive seizures. The latter develop gradually, starting from the facial muscles (up to 15-20 seconds), then switching to skeletal muscles (up to 30 seconds) and by the end of the attack — convulsions of the whole body. The time at which the general attack of eclampsia lasts takes up to 2 minutes. Also, a pregnant woman during an attack has dilated pupils, foam from the mouth, tongue biting, cyanosis.

As soon as the attack of eclampsia of pregnant women ends and a new one does not occur, the patient may begin to regain consciousness. Provided that the seizures continue, the seizures develop and have a regression — the woman falls into a coma. She will be in a serious condition for some time and whether she will be able to get out of it depends on many factors.

The seizure condition, in which eclampsia develops, can provoke any external factors that negatively affect the pregnant woman individually. It can become a bright light, noise, sound, scream, etc.

One of the features of eclampsia is the possibility of its occurrence during delivery. Labor eclampsia can develop due to severe pain syndrome, in the absence of analgesics for a pregnant woman, with extremely rapid labor activity, due to stimulation, which has a rapid development. Birth eclampsia can develop even after cesarean section.

Eclampsia is characterized by a convulsive seizure, cerebral edema, pulmonary edema, possible suffocation and cerebral hemorrhage, as well as premature placental abruption. In the future, it is possible to make a prognosis only after the attacks are over, in the absence of a coma. During eclampsia, the fetus may die in utero. Hypoxia of the fetus with its subsequent death is also possible.

Diagnosis of eclampsia
The diagnosis of eclampsia consists in measures aimed at recognizing this form of gestosis. There are such forms of brain damage as:

epilepsy;
aneurysm;
the tumor;
diabetic coma, which are similar in their signs to eclampsia.
The diagnosis of eclampsia cannot be carried out with the help of ultrasound examination, laboratory tests, etc.

The main diagnosis of the disease consists in careful monitoring of the pregnant woman from the first day of registration. After 22 weeks of pregnancy, it is necessary to observe gestosis and its forms in the patient.

CT and NMRI of the brain are individually performed to create a complete clinical picture.

Treatment of eclampsia
During treatment, a woman should be under the supervision of a doctor with round-the-clock connection to medical devices of different functionality. This is necessary for constant reading of indicators such as heart rate, blood pressure, ECG, EEG. Also, a device is connected separately to display the blood status on the monitor, count hemoglobin, erythrocytes, platelets.

The treatment of eclampsia is based on the conditions under which a woman is in an emotionally stable state, with the complete absence of any physical and moral stress on the body. In critical condition and severe eclampsia, treatment is carried out using a resuscitation kit. In the future, consultation and observation by a neurologist, a neurosurgeon is necessary. The passage of these specialists is mandatory for any form of eclampsia development.

It is mandatory during treatment to perform catheterization of the bladder. Eclampsia is treated with the introduction of glucose solutions, diuretics, magnesium sulfate, rheopolyglucine. These drugs are necessary to improve the overall metabolism of the body, relieve swelling of organs, reduce blood pressure, as well as to prevent the development of seizures.

Prevention of eclampsia
Preventive measures of the disease are based on the correct management of pregnancy and correction of the woman’s well-being. Careful collection of anamnesis, the construction of a curve of diseases in the genus allows you to identify the risk of possible eclampsia.

One of the forms of gestosis occurs in the late stages of pregnancy. To prevent this condition, it is necessary to keep records and monitor the patient from the first day of registration. An MRI diagnosis of the cerebral cortex is mandatory. Clinically confirmed is the fact that MRI does not pose a threat to fetal development in utero. That is why it is worth conducting this study in the early stages of a pregnant woman in order to eliminate the risk of an acute form of gestosis — eclampsia.

In addition, women with a history of endocrine system disorders: obesity; diabetes mellitus; thyroid dysfunction, etc., need not only to monitor the hormonal background individually, but also to monitor the balance of daily exercise and rest, the formation of a balanced diet.

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