II. Definitions
- Eclampsia ("sudden flash" or "shining forth")
- Most severe form of PIH characterized by Seizures
- Also referred to as Toxemia or "toxin present"
III. Epidemiology
IV. Pathophysiology
- Results from focal cerebral edema
- Associated with transient Vasoconstriction and ischemia
- Usually results from progressive Severe Preeclampsia
- May also occur with little warning
- Mild Preeclampsia may precede Eclamptic Seizure
-
Blood Pressure is only mildly increased in 30-60% of patients
- Up to 15% of cases have diastolic BP <90 mmHg
V. Signs
- See Preeclampsia
- Phase 0: Preceding symptoms
- Headache (80%)
- Visual changes (45%)
- Phase 1: Prodrome (brief)
- Twitching
- Facial congestion
- Mouth foaming
- Altered Level of Consciousness
- Phase 2: Tonic
- Muscle rigidity
- Phase 3: GTCS activity for 1 to 1.5 minutes
- Rhythmic Muscle Contractions and relaxation
- Generalized Tonic Clonic Seizure
- Loss of respiratory activity
- Fetal Bradycardia
- Phase 4: Comatose
- Respiratory effort, but otherwise comatose
- Phase 5: Post-ictal
- Confused and agitated, combative
VI. Management
VII. References
- Fontaine (2000) in ALSO, B:1-36
- Sibai in Gabbe (2002) Obstetrics, p. 945-74
- (2000) Am J Obstet Gynecol 183(1):S1-22 [PubMed]
- Leeman (2016) Am Fam Physician 93(2):121-7 [PubMed]
- Zamorski (2001) Clin Fam Pract 3:329-47 [PubMed]