Overview, Causes, & Risk Factors
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:
a first pregnancy
African American ethnicity
diabetes
high blood pressure before pregnancy
low socioeconomic status
maternal age below 20 or over 35
molar pregnancy, an abnormal condition that mimics a normal pregnancy but is actually a tumor
multiple gestation such as twins or triplets
preeclampsia or eclampsia in previous pregnancies
she or the baby's father was born of a pregnancy with preeclampsia or eclampsia
underlying kidney disease
No one knows why some women with preeclampsia develop the seizures associated with eclampsia. Theories about why seizures might occur in pregnancy involve:
small clots that block blood vessels in the brain and restrict oxygen
narrowing of tiny arteries in the brain
areas of bleeding in the brain
high blood pressure
dietary risks
genetic risks
a problem with the brain or nervous system
Symptoms & Signs
What are the signs and symptoms of the condition?
The symptoms of preeclampsia may include:
agitation and confusion
changes in mental status
decreased urine output
headaches
nausea and vomiting
pain in the right upper part of the abdomen
shortness of breath
sudden weight gain over 1 to 2 days
swelling of the face or hands
visual impairment
weight gain of more than 2 pounds per week
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:
bite her tongue
break bones
breathe fluids into her lungs
develop fluid and swelling in her lungs that make it hard to breathe
experience a detached retina in the eye
harm her head
Diagnosis & Tests
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:
complete blood count, or CBC, to look for abnormal blood cell counts
blood tests to check clotting and liver function
urinalysis to look for protein in the urine
cranial CT scan to check for bleeding or stroke
pregnancy ultrasound to check the age and condition of the fetus
If a woman develops seizures along with preeclampsia, she is then diagnosed as having eclampsia.
Prevention & Expectations
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:
increased risk for cesarean section
intrauterine growth retardation, a lack of normal growth of the baby within the womb
placenta abruptio, or separation of the placenta from the uterine wall
premature labor
stillbirth
suffocation at birth, or asphyxia
Eclampsia can also cause health problems that affect mother and baby, including:
acute renal failure, or kidney failure
disseminated intravascular coagulation, or DIC, a clotting problem that causes widespread bleeding
HELLP syndrome, which includes liver and blood disorders
intracerebral hemorrhage and stroke
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.
Treatment & Monitoring
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.
Homepage 
Health
Topics 
Pregnancy 
