Cardiovascular Medicine Book

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EclampsiaAka: Toxemia of Pregnancy, Eclamptic Seizure

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  1. Definitions
    1. Eclampsia ("sudden flash" or "shining forth")
      1. Most severe form of PIH characterized by Seizures
    2. Also referred to as Toxemia or "toxin present"
  2. Pathophysiology
    1. Results from focal cerebral edema
    2. Associated with transient vasoconstriction and ischemia
    3. Usually results from progressive Severe Preeclampsia
    4. May also occur with little warning
      1. Mild Preeclampsia may precede eclamptic Seizure
    5. Blood Pressure is only mildly increased in 30-60% of patients
      1. Up to 20% of cases have diastolic BP <90 mmHg
    6. Usually occurs prior to delivery
      1. Antepartum Seizure: 53% of cases
      2. Intrapartum Seizure: 19%
      3. Postpartum Seizure: 28%
        1. Majority (79%) of postpartum Seizures are late postpartum (>48 hours after delivery)
  3. Epidemiology
    1. Rare <20 weeks gestation (except in hydatiform mole)
  4. Signs
    1. See Preeclampsia
    2. Phase 1: Prodrome (brief)
      1. Twitching
      2. Facial congestion
      3. Mouth foaming
      4. Altered Level of Consciousness
    3. Phase 2: Tonic
      1. Muscle rigidity
    4. Phase 3: GTCS activity for 1 to 1.5 minutes
      1. Rhythmic muscle contractions and relaxation
      2. Generalized Tonic Clonic Seizure
      3. Loss of respiratory activity
    5. Phase 4: Comatose
      1. Respiratory effort, but otherwise comatose
    6. Phase 5: Post-ictal
      1. Confused and agitated
  5. Management
    1. See Eclamptic Seizure Management
  6. References
    1. Fontaine (2000) in ALSO, B:1-36
    2. Sibai in Gabbe (2002) Obstetrics, p. 945-74
    3. (2000) Am J Obstet Gynecol 183(1):S1
    4. Zamorski (2001) Clin Fam Pract 3:329

Eclampsia (C0013537)

Definition (MSH)Onset of HYPERREFLEXIA; SEIZURES; or COMA in a previously diagnosed pre-eclamptic patient (PRE-ECLAMPSIA).
Definition (CSP)convulsions and coma occurring in pregnant or puerperal women, associated with hypertension, edema, and proteinuria.
ConceptsDisease or Syndrome (T047)
MSHD004461
EnglishEclampsia, Eclampsia unspecified, Eclampsias, Eclamptic toxaemia, Eclamptic toxemia, Toxaemia with convulsions, Toxemia with convulsions
Spanisheclampsia, toxemia con convulsiones, toxemia eclampsica
Parent ConceptsPre-Eclampsia (C0032914), Hypertension induced by pregnancy (C0340274), Eclampsia (C0013537), Duplicate concept (C1274013)
SourcesCOSTAR, CSP, CST, DXP, MSH, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Eclamptic seizure (C0743381)

ConceptsDisease or Syndrome (T047)
EnglishEclamptic fit, Eclamptic seizure
Parent ConceptsSeizures (C0036572)
SourcesSNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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