eclampsia

a serious disease occurring during pregnancy, labor, or the postpartum period. Eclampsia is a late stage of toxemia of pregnancy. The condition is characterized by convulsions that develop in a definite sequence. Slight fibrillar contractions of the facial muscles (15–30 seconds) are followed by tonic spasms of the total skeletal musculature and loss of consciousness (15–20 seconds). Clonic muscular spasms of the trunk and limbs occur, and, finally, the woman lapses into a brief or prolonged coma. Consciousness returns gradually. In particularly severe cases, eclampsia may occur without convulsions (comatous forms). Eclampsia is often manifested by only a few convulsions, and high blood pressure may not be a symptom. Death may occur during or after convulsions as a result of pulmonary edema, hemorrhages into the brain, and asphyxia. The fetus often dies in utero from hypoxia. The prognosis depends on the number and duration of the convulsions or on the duration of the coma.

Current treatment of eclampsia is based on principles developed by the Soviet obstetrician-gynecologist V. V. Stroganov in 1928. Total physical and mental rest is prescribed. Functioning of the vital organs is restored: Drugs are administered to decrease the excitability of the central nervous system, to lower blood pressure, and to stimulate urination. Oxygen is administered in cases of pronounced hypoxia, and labor is induced quickly but cautiously. The patient should not be moved during convulsions or while in a coma. Prompt hospitalization is required as soon as consciousness is regained. Prophylaxis includes the prevention of advanced toxemia and prompt hospital treatment of neuropathy and preeclampsia.