During the bearing of the baby, each expectant mother carefully monitors the state of her health. After all, much depends on this, including the development of the baby. In this article, I want to talk about such a problem as eclampsia in pregnant women.
Terminology
Initially, you need to understand the terminology that will be used in this article. So, eclampsia is primarily a dangerous pregnancy complication, when there is a threat to the life of not only the child, but even the mother herself. However, do not be scared - this condition occurs extremely rarely. Such problems appear no more than 1 time per 100 pregnancies. It must also be said that eclampsia is a complication precisely in the period of toxicosis, the highest degree of this unpleasant condition.
Causes of the problem
It is worth noting that doctors do not yet know the exact causes of this condition in women. However, the following are still distinguished:
- Genetic factor. Those. if similar problems have already occurred in a woman’s family.
- Often this condition is repeated. This means that if, during a previous pregnancy, a woman has experienced eclampsia, the problem may recur.
- According to doctors, the age of the woman in labor also affects the occurrence of pathology. It is believed that more often such a complication occurs in those women who are not yet 18 or older than 40 years old.
- Eclampsia often occurs with multiple pregnancy.
- Very often, this pathology occurs in those women who have various kidney problems. It often develops against the background of an acute disease of these organs.
- The cause can also be a disease such as systemic lupus erythematosus.
It is also worth noting that eclampsia is a complication during which an increase in blood pressure occurs very sharply. And this, in turn, leads to vasospasm, which causes various kinds of circulatory disorders and, as a result, cerebral edema.
Accompanying problems and diseases
Doctors also say that eclampsia in pregnant women is often accompanied by various conditions. Those. There are some moments against which a problem such as eclampsia often manifests itself.
- Arterial hypertension. It has already been said above that eclampsia often manifests itself against the background of high blood pressure. But nevertheless, this complication also occurs in women with normal blood pressure (in about 16% of cases). It is also worth noting that if a pregnant woman has severe hypertension, eclampsia will appear in her by the 32nd week.
- Proteinuria (protein in the urine). Doctors also say that everyone with eclampsia has varying degrees of proteinuria. However, in 14% of women this problem is still absent.
- Often eclampsia is accompanied by swelling. However, this condition may not occur in a pregnant woman (this happens in about 28% of cases).
Manifestation of eclampsia
From the foregoing, it became clear that eclampsia is such a complication of pregnancy when there is a threat to the life of not only the baby, but also the woman herself. However, it is worth noting that this condition can also occur even before conception, as well as after childbirth.
Modern reviews indicate that postpartum eclampsia occurs most often on the second day after delivery. However, this can happen much later, after about 28 days. Such cases were also recorded by doctors. Statistics also indicate that most often this problem manifests itself in the second half of pregnancy (after the 28th week in 91% of cases). But it may occur before the 20th week of bearing a baby (however, only in 1.5% of cases).
Types of Eclampsia
It must also be said that in medicine there are three main types of eclampsia:
- Brain In this case, the main reason is fluctuations in blood pressure, arterial hypertension. Ischemic and hemorrhagic strokes may also develop as complications.
- Renal eclampsia. In this case, the seizures are convulsive, and a coma is accompanied by anuria.
- Hepatic eclampsia. In this case, doctors talk about the deepest metabolic disorders.
The main symptoms
Be sure to also consider the various signs of eclampsia. This is important, because every woman should know how to distinguish this pathology. Generally speaking, eclampsia is the occurrence of seizures with loss of consciousness. However, the cause of this condition should not be associated with any cerebral pathology. It is also worth noting that almost any factor can provoke an attack in a woman. This can be the most common bright light, a loud knock, or strong negative emotions.
Before convulsions, a woman most often experiences the following symptoms:
- Headache may occur. Dizziness is also common.
- There may be various kinds of visual impairment: “flies” in front of the eyes, blurred vision, blurry pictures.
- Women often have a general weakness in the whole body, a desire to immediately sit down or lie down.
- There may also be pain in the epigastric region or in the region of the right hypochondrium.
The main symptom: cramps
Considering the various signs of eclampsia, it is worth noting that the main symptom in this case is convulsions. They arise and develop in a certain order. So, the phases of seizures are distinguished by the following:
- The first phase lasts approximately 30 seconds. Small contractions of the facial muscles occur. Twitching can also go to the upper limbs.
- The duration of the second phase is approximately 25-30 seconds. So-called tonic convulsions occur. The woman's body bends, her head throws back. In this case, breathing is intermittent, delayed. Jaws tighten tightly. It is worth noting that although this period is not too long, it is still the most dangerous one. After all, it is here that a rapid hemorrhage in the brain can occur , which will cause instant death or a coma.
- The third phase takes about a minute and a half. Here, mainly clonic convulsions are observed, i.e. twitching of the muscles of the whole body, limbs. Breathing can be either intermittent or completely absent. Foam is often released from the mouth. In this case, the pupils dilate, loss of consciousness may occur. At the end of this phase, the pregnant woman’s breathing gradually begins to adjust, to become normal.
- The fourth phase in doctors is called an eclampic coma. The woman's breath is noisy, loud. Often at first the lady is unconscious. When it comes back, the pregnant woman does not remember anything and does not understand what happened to her. Basically, this phase is accompanied by severe headache.
It is worth noting that after the fourth phase, a new seizure may occur. An eclampic coma can last even a day, during which time a woman can survive about 15-18 seizures. The prognosis after this is made by the doctor based on the examination of the patient, if necessary, additional studies are carried out.
The manifestation of eclampsia in the postpartum period
As already mentioned above, there is also eclampsia after childbirth. It can begin both during the process of the birth of the baby, and after it (on the first day). It should also be noted that this condition often leads to severe complications, such as acute renal failure or the so-called HELLP syndrome. It manifests itself as follows.
- The content of the most important enzymes in the liver changes, which can lead to serious damage.
- Hemolysis, the destruction of red blood cells, may also occur.
- A sharp decrease in platelet count may also occur. This thrombocytopenia is a complex disorder that affects blood coagulation.
It is worth noting that if postpartum eclampsia does not threaten the life of the child, then this is an extremely dangerous condition for the mother. Therefore, this problem requires immediate treatment.
Prognosis for eclampsia
This is a problem like eclampsia. Symptoms have already been considered sufficiently. It should also be noted that doctors can give predictions after this complication based on the following factors.
- The severity of the disease. In this case, all the symptoms and the brightness of its manifestation are taken into account.
- The most important factor is the severity of the seizures and their frequency. The more of them, the worse.
- The prognosis is also affected by the timely intervention of doctors. If assistance was provided on time, the prognosis can be extremely positive.
- Of course, the subsequent course of pregnancy is affected by the presence, as well as the nature of the complications.
Factors Affecting Forecast
The prognosis will be positive if seizures become less and less frequent. Also a positive factor is an increase in the amount of urine excreted.
The forecast will be negative in the following cases:
- if seizures follow each other;
- when their frequency increases;
- if there is an increase in temperature to about 38 ° C;
- when arrhythmia is observed, increased heart rate.
If an eclampsia attack results in hemorrhage in any organs, this is considered a serious complication of this problem. With poor search of medical staff, a pregnant woman can inflict serious bodily injuries during seizures, up to biting her tongue.
It is also worth noting that various kinds of degenerative changes in various organs (most often in the kidneys or liver) can become the cause of death, which is possible with the long-term development of this problem.
Diagnostics: laboratory tests
We figured out what eclampsia is, the symptoms and causes of complications are also considered by us. Now we turn to methods for diagnosing this disease. So, if a woman had a seizure to confirm this diagnosis, the following laboratory tests can be prescribed for a pregnant woman:
- blood coagulation test;
- determination of hemoglobin level;
- checking the level of uric acid and other important components in the blood serum.
Diagnosis: other studies
If a lady had an attack of eclampsia, in addition to blood tests, other procedures will be prescribed to her.
- Chest x-ray. If necessary, an X-ray of the brain can be performed (however, this is done in extreme cases).
- Examination of the child. This is very important, because during an attack of the mother, the fetus may develop bradycardia, hypoxia. Detachment of the placenta may also occur.
The doctor makes a diagnosis based on the results of the above studies.
Treatment for this problem
Today, the following treatment for eclampsia is used: a woman is injected with magnesium sulfate intravenously . The introduction of this drug significantly reduces the risk of seizures. Moreover, its activity persists for two days. Less effective drugs, which, however, doctors also prescribe: drugs "Phenytoinum" or "Valium." But you need to remember that their use is fraught with the occurrence of side effects. When the patient’s condition is stabilized, doctors prepare the woman for cesarean section or artificial vaginal delivery. If the terms of carrying the baby are extremely early, the decision on delivery can only be made by a consultation of doctors.
Helper Methods
Help with eclampsia is not just about medication. So, it is very important to observe the following recommendations if a lady has a risk of having a seizure again.
- Any irritants must be removed immediately.
- Doctor V.V. Stroganov recommends systematically administering drugs to a woman, for example, "Morphine." This will help to avoid seizures.
- Relieving seizures. Those. It is worth trying to avoid their development when the first signs appear.
- It is important to monitor the work of all body functions, the necessary ones are to improve.
- It is necessary to monitor fluctuations in blood pressure. With an increase it needs to be reduced.
Preventative methods
Every pregnant woman must know what the prevention of eclampsia should be. After all, it is better to prevent the occurrence of a problem than to deal with its consequences. So, the prevention of eclampsia today is carried out by the following methods.
- Prophylactic administration of magnesium sulfate. In this case, the frequency of eclampsia is reduced by about 60%. However, this question is still open. So, for women with severe preeclampsia, this drug must be administered accurately. But with a light form - it is not yet clear.
- It is also important to carefully monitor fluctuations in blood pressure in a pregnant woman.
- It is necessary to treat various complications of toxicosis. It is also important to identify their cause.
By adhering to these recommendations, you can avoid the appearance of a problem such as eclampsia. And, of course, it is worth remembering that at the first doubt or suspicion of a problem, a woman should immediately seek medical help.