This presentation discusses eclampsia, a pregnancy complication characterized by seizures in women with pre-eclampsia. It defines eclampsia and outlines its risk factors like first pregnancy, hypertension, and obesity. The presentation covers the pathophysiology, onset, clinical manifestations in four stages from premonitory to coma, potential complications, and management focusing on arresting convulsions, oxygen administration, terminating pregnancy, anti-hypertensive drugs, and timely delivery.

1. PRESENTATION
ON ECLAMPSIA
SUBJECT: MIDWIFERY AND OBSTETRICS
BY: ANPINDER KAUR
TO: MS.MANDEEP KAUR
ASSOCIATE PROFESSOR

2. •

3. CONTENTS
• Definition
• Risk factors
• Pathophysiology
• Onset
• Clinical manifestations
• Complications
• Prevention
• Management

4. INTRODUCTION
•Pregnancy specific disorder
•Complication of pre-eclampsia
•Affects central nervous system [CNS]

5. DEFINITION
•Pre-eclampsia when
complicated with
generalised tonic-clonic
convulsions and/or
coma is called
eclampsia.

6. RISK FACTORS
• First pregnancy
• Multiple gestations
• Mothers <20 years
or >35 years
• Hypertension

7. RISK FACTORS
•Uncontrolled
diabetes
•Obesity
•Family history

8. PATHOPHYSIOLOGY
Exact cause is unclear
Key feature: development of
ABNORMAL placenta

16. ONSET
•Antepartum
period [50%]
especially during
3rd trimester

17. ONSET
•Intrapartum
period [30%]

18. ONSET
•Postpartum period
[20%] most likely
within 48hrs of
delivery

19. CLINICAL MANIFESTATIONS
Eclamptic convulsions
consists of 4 stages
•Premonitory stage
•Tonic stage
•Clonic stage
•Stage of coma

20. PREMONITORY STAGE [30 secs]
Other names
Prodrome
Pre-ictal stage
Features
Headache
Light headedness
Slurred speech

21. PREMONITORY STAGE [30 secs]
•Sleep
disturbances
• Nausea &
vomiting
• Aura

22. TONIC STAGE [20-30 secs]
Spasm of voluntary
skeletal muscle
fibres
• Flexion of limbs
• Clenching of hands
• Eye balls roll over

23. TONIC STAGE [20-30 secs]
•Breathing
stops
•Cyanosis
•Opisthotonos
position

24. CLONIC PHASE [1-4 mins]
•Breathing restarts
•Cyanosis disappears
•Eye balls are fixed up
•Tongue bite

25. COMA STAGE [POST-ICTAL STAGE]
•Deep sleep
•Confusion
•Fails to
remember
•Unconscious

26. COMA STAGE
•Status eclampticus
appearance of tonic-
clonic phase multiple
times before the patient
awakes

27. COMPLICATIONS
Injuries:
•Tongue bite
•Fall from
bed

28. COMPLICATIONS
Pulmonary
complications:
•Pneumonia
•Respiratory distress
syndrome

29. COMPLICATIONS
•Cerebral:
haemorrhage
•Disturbed
vision: retinal
detachment

30. COMPLICATIONS
•Postpartum:
shock, sepsis,
psychosis

31. MANAGEMENT
AIM OF MANAGEMENT
• Arrest convulsions
• Maintain patent airway, breathing and circulation
• Oxygen administration @ 8-10 L/min
• Terminate pregnancy
• Prevention of life threatening situation

32. MANAGEMENT
Prevention
• Early detection
• Effective institutional
treatment
• Anti-hypertensive drugs

34. MANAGEMENT
Prevention
•Anti-convulsant therapy
•Timely delivery
•Close monitoring

36. SUMMARY