Preeclampsia and eclampsia – are forms of pregnancy – induced - hypertension. PIH is a condition characterized by development of high blood pressure, edema and proteinuria in pregnant women . It has been estimated that PIH affects about 7 to 10% of all pregnancies .
Preeclampsia, also known as toxemia is characterized by high blood pressure and high levels of protein in the urine of women after the 20th week of gestation . Preeclampsia, usually strikes women in their first pregnancy, or those who are carrying twins.
Eclampsia is a serious complication of pregnancy characterized by life threatening acute tonic – clonic seizures in a pregnant woman. It is a fatal condition and is the second leading cause of maternal death in the United States. Eclampsia essentially occurs in those women who already have had preeclampsia and which possibly was not treated on time . Research has it documented that, about 1 in 200 women who have had preeclampsia, eventually also develop eclampsia .
Signs and Symptoms
Medical practitioners and prenatal caregiver, always stress upon the fact that pregnant women should always be vigilant and call the emergency in case they notice any of the following signs :
- Sudden swelling of hands, face and feet
- Intense pain in the upper abdominal region
- Intense headaches which refuses to subside with over the counter medications
- Blurred vision and or appearance of spots in front of the eyes
If preeclampsia is detected in the early stages, then it can be managed effectively and development of eclampsia can also be prevented.
The characteristic symptom of eclampsia is convulsions and seizures. The rest of the signs and symptoms are more or less similar to preeclampsia, but may vary depending on the organ affected. Below is a list of symptoms that may develop in pregnant women who have eclampsia [7, 8].
- High blood pressure above 160 / 110 mm Hg
- Increase in the quantity of protein in urine
- Abdominal pain
- Cortical blindness
- Nausea and vomiting
- Muscle aches
- Loss of consciousness
The exact causes of preeclampsia and eclampsia are unknown – but there are certain factors that are known to play foul . The causative factors for preeclampsia include :
- Poor blood flow to the uterus
- Blood vessels that get damaged
- Diet deficient in nutrients
- Problem with the immune system
Eclampsia that is marked by the onset of seizures, have causative factors similar to those of preeclampsia. The other causative factors include [4, 11]:
- Mothers with preeclampsia
- Faulty diet and
- Irritability of the central nervous system and brain
Preeclampsia and eclampsia usually strikes women who conceive at a younger age or at an older age which is above 40 years . The other risk factors for preeclampsia include the following :
- History of preeclampsia
- New pregnancy
- New partner each time for new pregnancy
- Multiple pregnancies
- Diabetes and gestational diabetes
- Long interval between 2 pregnancies
Risk factors for eclampsia and preeclampsia do not differ much. These are :
- Risk of developing eclampsia is higher in nulliparous women as compared to parous women.
- Being overweight
- Longer birth interval
- Low socio economic status
- Being obese before conceiving
- Gestational diabetes
Treatment of preeclampsia is mainly aimed at preventing the development of eclampsia. Therefore, in view of this, timely delivery of the baby is the best option available. However, if the pregnant woman is her early stages of pregnancy then delivery may not be the best option for her baby .
If preeclampsia is mild then drugs for lowering blood pressure along with bed rest is advised. The patient may even be required to be retained in the hospital for monitoring her blood pressure. If preeclampsia is too severe and the delivery of the baby is not possible then the woman is given corticosteroids for improving platelet functioning that in turn helps to prolong the pregnancy period .
Eclampsia is usually treated with magnesium sulphate which has been proved to be effective as well as safe for both the mother and baby. In conditions when the drugs fail to keep the blood pressure under control and the baby is in distressed condition; the preferred mode of treatment is prompt delivery of the baby. But if the conditions are not conducive for delivery and lungs of the baby has also not matured then steroids drugs are given .