How does eclampsia develop?
The basis is a violation of the formation of blood vessels in the placenta in the early stages of pregnancy. Because of this, substances are released into the mother’s blood that damage the internal lining of the blood vessels of the entire body. Vessels spasm, pressure increases, fluid leaves the bloodstream into the tissues, the kidneys, liver, coagulation system and brain suffer. When the regulation of cerebral blood flow is disrupted and swelling of areas of the brain develops, a seizure occurs. It is important that eclampsia can develop after childbirth, most often in the first few days, so observation continues in the postpartum period.
- Violation of the formation of blood vessels of the placenta
- Damage to the internal lining of blood vessels
- Vasospasm and increased blood pressure
- Damage to the kidneys, liver and coagulation system
- Impaired cerebral blood flow and cerebral edema
- Seizures during pregnancy, childbirth and after childbirth
Precursors and symptoms
Most often, an attack is preceded by warning signs that every pregnant woman should be aware of. This is a persistent headache that is not relieved by rest, visual disturbances in the form of spots, flashes or a veil, pain in the epigastric region or under the right rib, nausea and vomiting in the second half of pregnancy, a sharp increase in edema and rapid weight gain. The attack itself begins with twitching of the facial muscles, then a phase of tension of the whole body begins, followed by convulsive twitching, after which the woman loses consciousness and gradually comes to her senses, not remembering what happened.
- Persistent headache
- Floaters, flashes, veils before the eyes
- Pain under the right rib or in the epigastric region
- Nausea and vomiting late in pregnancy
- A sharp increase in swelling of the face and hands
- High blood pressure and protein in urine
- Convulsive attack with loss of consciousness
First aid before the ambulance arrives
If a pregnant woman has a seizure, the main thing is to immediately call 103 and protect her from injury. The woman is laid on her left side on a flat surface, hard and sharp objects are removed nearby, and something soft is placed under her head. You cannot unclench your teeth, insert a spoon or fingers between them, hold them with force, give them something to drink, or put medicine in your mouth. After the attack ends, you need to clear your mouth of vomit, if it is safe to do so, and maintain the position on your side. Until doctors arrive, it is important to remain nearby and note the onset time and duration of the attack.
- Call 103 immediately
- Lay on your left side on a flat surface
- Remove hard objects and protect your head
- Do not hold with force or unclench your jaw
- Do not give anything by mouth
- After an attack, ensure airway patency
- Remember the time and duration of the attack
Help in hospital
Treatment is carried out in the intensive care unit of an obstetric hospital. The drug of choice for stopping and preventing seizures is magnesium sulfate, which is administered according to a strict regimen under the control of breathing, reflexes and urination. At the same time, blood pressure is reduced to safe values, preventing its sharp drop, since this impairs blood flow in the placenta. The condition of the fetus is assessed and blood and urine tests are performed. The only radical solution is delivery: the date and method are determined by the medical team based on the condition of the mother, child and the duration of pregnancy.
- Admission to the intensive care unit
- Magnesium sulfate for the relief and prevention of seizures
- Controlled reduction of blood pressure
- Fetal monitoring
- Monitoring blood tests, liver tests, platelets and creatinine
- Delivery as the main method of treatment
- Continued observation and therapy after childbirth
Prevention and monitoring after childbirth
Preeclampsia cannot be completely prevented, but the risk can be significantly reduced. For women at risk, the doctor prescribes prophylactic administration of low doses of acetylsalicylic acid starting from the end of the first trimester and calcium supplements if calcium intake is insufficient. Regular follow-up is key, with blood pressure taken and urine protein tested at every visit. After eclampsia, observation continues: such women have a higher risk of high blood pressure and cardiovascular diseases in the future, so they are recommended to control blood pressure and have a healthy lifestyle.
- Early registration and regular visits
- Blood pressure measurement and urine protein test at every visit
- Low doses of acetylsalicylic acid in risk groups as prescribed by a doctor
- Calcium supplements for insufficient intake
- Know the warning signs and plan for action
- Observation in the first weeks after birth
- Monitoring blood pressure and weight in the long term
