Are You a woman? Do You have a wife, sister, friends? You need to read this thought provoking piece on Eclampsia. Doctors keep writing about eclampsia because it is a killer.
Few years ago while in medical school I was reading with some friends at the Obstetrics and Gynaecology unit of the Hospital. Usually, we chose to read there because it was empty, well lit and calm on some nights even though on some other nights it was very busy with women in labour or those who need some form of emergency services. We always watched the celebrations once the new baby arrived, the relief on the mother’s face after hours of pain and tears.
This particular night was very quiet until suddenly two men rushed into the reception screaming and calling for help; they needed a doctor immediately.
The nurses wheeled in a fair young woman, convulsing and twitching on every part of her body. This was at 2:00am. She was 36wks pregnant and was referred from a private hospital where they had tried to manage her condition to no avail.
Promptly, we left our books to help the doctor on call. He administered every drug necessary and she was stable, there was need to deliver her baby by the fastest means possible at this time the consultant had arrived and she was prepared for the theatre.
At exactly 2:45am the surgery commenced; a caesarean section was performed, her family members were praying and we also prayed silently for her. The doctor came out from the theatre at 4:00am with the news that she was dead but the baby survived, her husband and other relatives was so distraught there were cries from every corner and I still can’t get her face out of my mind. This is just one out of thousands of pregnant women that have died due to pre-eclampsia that deteriorated to Eclampsia.
Pre-eclampsia is a multi-systemic disorder characterized by hypertension and proteinuria which often develops after the 20th week of pregnancy in a previously normotensive woman resolving completely by the 6th week postpartum.
Hypertension, according to World Health Organization, is systemic Blood pressure greater than or equal to 140mmHg and diastolic Blood pressure greater than or equal to 90mmHg.
The cause of Pre-eclampsia is essentially unknown but their are a lot of theories as to why it occurs, it is referred to as ‘the disease of theories’. The central pathology to the development of Pre-eclampsia lies in the placenta, it is said to be caused by abnormal placentation whereby the spiral arteries that supply the placenta maintain their pre-pregnancy characteristics resulting in impaired blood supply.
It complicates approximately 2-3% of pregnancies
Risk factors for developing pre-eclampsia includes:
- First pregnancy (primigravida)
- Age: extremes of age
- Body mass index of 35 or more
- Pre-eclampsia in previous pregnancy
- Ten years or more since last baby
- Family history of pre-eclampsia (in mother or sister)
- Certain underlying medical conditions e.g. pre-existing hypertension, diabetes and renal disease
Patient maybe not experience any symptoms but some classic symptoms include:
- Frontal headache
- Visual disturbance
- Leg, hand and facial swelling.
Complications of Pre-eclampsia;
- Acute renal failure
- Pulmonary oedema
Management of Pre-eclampsia:
There’s no cure but ending the pregnancy by delivering the baby and the placenta usually relieves all symptoms. This may require delivering the baby prematurely in order to prevent progression into Eclampsia which is more life threatening and involves seizures.
In patient management is required in serious cases for continuous monitoring of the mother and the baby. There’s need for continuous check ups until 6weeks postpartum to ensure resolution of symptoms.
Early registration and constant attendance of Antenatal care is very vital for Early detection and proper management of this condition.
Written by Dr Queen UDOEZE.