Eclampsia

2. • Pre-eclampsia when complicated with
generalized tonic clonic convulsions and/or coma
is called eclampsia.
• Pre-eclampsia is a multisystem disorder of
unknown etiology characterized by development of
hypertension to the extent of 140/90 mm Hg or
more with proteinuria after the 20th week in a
previously normotensive and nonproteinuric
woman.
Definition

3. Incidence
• The incidence varies widely from country to
country and even between different zones of the
same country.
• It is more common in primigravidae (75%),
• five times more common in twins than in
singleton pregnancies and
• occurs between the 36th week and term in more
than 50%.
• 50% of seizures occur during labor, 25% before
labor, 25% after labor (1-48hrs).
• Maternal mortality 1 in 50. Fetal mortality 1 in 14

4. Causes of convulsion
• (1) Anoxia — spasm of the cerebral vessels →
increased cerebral vascular resistance → fall in
cerebral oxygen consumption→ anoxia,
• (2) Cerebral edema — may contribute to irritation,
• (3) Cerebral dysrhythmia — increases following
anoxia or edema. There is excessive release of
excitatory neurotransmitters (glutamate).
The cause of cerebral irritation leading to convulsion is
not clear. The irritation may be provoked by:

5. Symptoms
• Preceding:
• Headache
• Hyperactive reflexes
• Marked proteinuria
• Generalized edema
• Visual disturbances
• RUQ and epigastric pain
Maternal complications
• Tongue biting
• Head trauma
• Aspiration
• Permanent CNS damage
• Intracranial hemorrhage
• Renal failure
• Visual disturbances
• Psychosis
• Shock
• Death
Fetal complications
• Prematurity
• Intrauterine
growth restriction
• death

6. management
1)ABC of resusctitation – Airway,
Breathing, circulation
2)Control seizures – Magnesium Sulfate
3)Control Hyperternsion – hydralazine,
labetalol
4)Daliver if not postpartum –labour
inductionor C-section

7. Thank You