Toxemia with Seizures - Eclampsia

Preeclampsia is high blood pressure that develops or increases during pregnancy. Eclampsia is a complication of severe preeclampsia that involves seizures.

What is going on in the body?

The placenta is the spongy material in the mother's uterus that nourishes the fetus. Some experts believe that a problem with the placenta causes preeclampsia. The mother has spasms of the blood vessels, which increase her blood pressure. The blood flow to the placenta is impaired. If the blood pressure is not controlled, it can damage the placenta and cause the death of the fetus.

Preeclampsia develops in 5% of pregnant women. It usually occurs after the 20th week of pregnancy. It may be mild or severe. The high blood pressure can affect the brain, kidneys, liver, and lungs. If the high blood pressure in the brain causes bleeding into the brain, the woman may have seizures. This complication is called eclampsia.

One in 200 pregnant women who have preeclampsia will go on to have eclampsia. The seizures of eclampsia are marked by general abnormal electrical activity in the brain. Usually the seizures start before the baby is born. However, about 20% to 25% of the time, seizures begin within the first 24 hours after the baby is born. A few women develop seizures later, up to 3 weeks after the birth.

What are the causes and risks of the condition?

Factors that increase a woman's risk of preeclampsia are:

No one knows why some women with preeclampsia develop the seizures associated with eclampsia. Theories about why seizures might occur in pregnancy involve:

What are the signs and symptoms of the condition?

The symptoms of preeclampsia may include:

Women who have these symptoms are at high risk for eclampsia. Usually there are no clues or warning signs before a seizure. A woman with eclampsia may have one or many seizures. The seizures cause muscle spasms, loss of consciousness, and short-term memory problems. Afterward, the woman may breathe very rapidly to make up for the lack of oxygen during the seizure itself. A fever at this point is a sign of serious trouble.

During or after a seizure, a woman may:

How is the condition diagnosed?

Diagnosis of preeclampsia begins with a medical history and physical exam. The woman's blood pressure will be measured. The healthcare provider may order the following tests:

If a woman develops seizures along with preeclampsia, she is then diagnosed as having eclampsia.

What can be done to prevent the condition?

There are no known ways to prevent preeclampsia or eclampsia. All pregnant women should have early prenatal care. Blood pressure changes should be watched closely.

What are the long-term effects of the condition?

Eclampsia may cause pregnancy complications, including:

Eclampsia can also cause health problems that affect mother and baby, including:

Rarely, a mother with eclampsia dies due to blood clots, liver or kidney failure, infection, or other complications. Women who have had eclampsia also have a higher lifetime risk of developing high blood pressure and dying due to heart attacks or strokes.

What are the risks to others?

Eclampsia is not contagious. Both mother and baby are at risk for complications of preeclampsia and eclampsia.

What are the treatments for the condition?

Eclampsia is treated by delivering the baby. If the baby is older than 28 weeks, a cesarean section is usually done. During a C-section, the baby is delivered through an incision made in the abdomen. Prolonging the pregnancy can harm the mother or cause the baby to die.

Before a C-section is done, the mother's seizures and blood pressure may need to be controlled with medicines. Magnesium sulfate is the medicine of choice to prevent and control seizures. Diazepam may be used if the magnesium sulfate doesn't stop seizures. Medicines such as hydralazine and labetalol can be used to lower the blood pressure.

What are the side effects of the treatments?

A C-section may cause bleeding, infection, or even death. Medicines used to treat eclampsia may cause low blood pressure, breathing difficulties, nausea, or allergic reactions.

What happens after treatment for the condition?

After the baby is born, a woman may still have seizures for up to 6 weeks. Her provider will closely monitor blood pressure, urine and blood tests, and any other symptoms. If a baby is born prematurely and has health problems, hospitalization and care will be needed.

How is the condition monitored?

Preeclampsia often recurs in later pregnancies. Early prenatal care is key to recognizing warning signs and managing the condition. Any new or worsening symptoms should be reported to the healthcare provider.

Author:Eva Martin, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:07/31/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:06/26/01