Facts and Definition of Eclampsia:

Eclampsia, a life-threatening complication of pregnancy.

Eclampsia is a condition that causes a pregnant woman,

usually previously diagnosed with preeclampsia (high blood
pressure and protein in the urine), to
develop seizures or coma. In some cases, seizures or coma
may be the first recognizable sign that a pregnant woman
has had preeclampsia.

Eclampsia is a rare but serious condition that causes

seizures during pregnancy. Eclampsia is a severe
complication of preeclampsia.

Seizures are periods of disturbed brain activity that can

cause episodes of staring, decreased alertness, and violent
shaking (convulsions). Eclampsia affects about 1 in every
200 women with preeclampsia. You can develop eclampsia
even if you dont have a history of seizures.

What Causes Eclampsia?

Preeclampsia can cause your blood pressure (the force of
blood against the walls of your arteries) to become high
enough to damage your arteries and other blood vessels.
Damage to your arteries may restrict blood flow and
produce swelling in the blood vessels of your brain. If this
swelling interferes with your brains ability to function,
seizures may occur.

Since the exact cause of preeclampsia or eclampsia is

poorly understood, it is not possible to effectively predict
when preeclampsia or eclampsia will occur, or to enact
any preventative measures that might prevent these
problems from developing.

Preeclampsia usually occurs during an initial (first)

pregnancy.

Who Is at Risk for Eclampsia?

If you have or have had severe preeclampsia, you
may be at risk for eclampsia.

Other risk factors for seizures during pregnancy

include:

hypertension (high blood pressure)

 headaches
over age 35
under age 20
pregnant with twins
pregnant for the first time
history of poor diet or malnutrition
diabetes or another condition that affects your blood vessels

What Are the Signs and Symptoms of

Eclampsia?
Because preeclampsia can lead to eclampsia, you may have the
symptoms of both conditions. However, some of your symptoms
may be due to other conditions, such as kidney disease or
diabetes. Its important to tell your doctor about any conditions
you have so they may rule out other possible causes.

The following are common symptoms of preeclampsia:

swelling in your face or hands

headaches
excessive weight gain
nausea and vomiting
vision problems
problems urinating

The following are common symptoms of eclampsia:

seizures
loss of consciousness
agitation
headaches or muscle pain

The most common sign of preeclampsia is elevated blood

pressure and is also found in eclampsia. Again, the patient
may be unaware that she is hypertensive.

The kidneys may be unable to filter the blood efficiently.

There may also be an abnormal excretion of protein in the
urine. The first sign of excess urinary protein is usually
 determined on a urine specimen obtained at the time of a
routine prenatal visit. It is unusual for a patient to experience
symptoms related to excess urinary protein loss. In rare
cases there may be excretion of a large amount of urinary
protein.

Nursing Responsibilities
1. Monitor for, and promote the resolution of, complications.
o Monitor vital signs and FHR.

o Minimize external stimuli; promote rest and relaxation

o Measure and record urine output, protein level, and
specific gravity.
o Assess for edema of face, arms, hands, legs, ankles,
and feet. Also assess for pulmonary edema.
o Weigh the client daily.
o Assess deep tendon reflexes every 4 hours.
o Assess for placental separation, headache and visual
disturbance, epigastric pain, and altered level of
consciousness.

Test Findings

>40%
?5.5 mg/d
Blood >6.0 mg/dL (seve
Hematocrit
Renal Function ?1.0 mg/d
Serum uric acid 2.0-3.0 md/dL (sev

Creatinine <150 mL/m

Creatinine clearance 8-10 mg/dL (seve

BUN 10-16 mg/dL (sev

Coagulation <100,000 mL (sev

Platelets ?16 g/mL (seve
Fibrin degradation products

2. Provide treatment as prescribed.

o Mild preeclampsia treatment consists of bed rest in left
lateral recumbent position, balanced diet with moderate
to high protein and low to moderate sodium, and
administration of magnesium sulfate
o Severe preeclampsia treatment consists
of complete bed rest, balanced diet with high protein and
low to moderate sodium, administration of sulfate, fluid
and electrolyte replacements and sedative hypertensives
 such as diazepam or phenobarbital or an anticonvulsant
such as phenytoin
o Eclampsia treatment consists of administration of
magnesium sulfate intravenously
3. Institute seizure precautions. Seizures may occur up to 72
hours after delivery.
4. Address emotional and psychosocial needs.

What Are the Treatments for Eclampsia?

Delivering your baby is the only way to treat preeclampsia and

eclampsia. If your doctor diagnoses you with preeclampsia, they
may monitor your condition and treat you with medication to
prevent eclampsia from developing. If you do develop eclampsia,
your doctor may deliver your baby early, depending on how far
along you are in your pregnancy. Early delivery may occur
between 32 and 36 weeks of pregnancy if life-threatening
symptoms arise or if medication doesnt work.

Medications
Medications to prevent seizures (anticonvulsants) may be
necessary. You may also need medication to lower blood
pressure if you have high blood pressure.

Home Care
Taking all prescribed medications, getting rest, and monitoring
any changes in your condition are critical for managing
preeclampsia and eclampsia.

Risks after Pregnancy

In uncomplicated preeclampsia, the mother's high blood pressure
and increased protein in the urine usually resolve within 6 weeks
of the infant's birth. Studies, however, have shown that women
who have had preeclampsia are four times more likely to develop
hypertension and twice as likely to develop ischemic heart
disease (reduced blood supply to the heart muscle, which can
cause heart attacks), a blood clot in a vein, and stroke.
Less commonly, mothers who had preeclampsia during
pregnancy could experience permanent damage to their organs.
Preeclampsia could lead to kidney and liver damage or fluid in the
lungs.

References:
https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/Pages/risk-mother.aspx

http://nursingcrib.com/nursing-care-plan/nursing-care-plan-pregnancy-induced-hypertension-pih-
preeclampsia-and-eclampsia/

http://www.healthline.com/health/eclampsia#Outlook7

http://www.emedicinehealth.com/eclampsia/page2_em.htm