Eclampsia history and symptoms
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Histroy and Symptoms
Typically patients show signs of pregnancy-induced hypertension and proteinuria prior to the onset of the hallmark of eclampsia, the eclamptic convulsion. Other cerebral signs may precede the convulsion such as nausea, vomiting, headaches, and cortical blindness. In addition, with the advancement of the pathophysiological process, other organ symptoms may be present including abdominal pain, liver failure, signs of the HELLP syndrome, pulmonary edema, and oliguria. The fetus may have been already compromised by intrauterine growth retardation, and with the toxemic changes during eclampsia may suffer fetal distress. Placental bleeding and placental abruption may occur.
The Eclamptic Seizure
Chesley distinguishes these four stages of an eclamptic event: In the stage of invasion facial twitching can be observed around the mouth. In the stage of contraction tonic contractions render the body rigid; this stage may last about 15 to 20 seconds. The next stage is the stage of convulsion when involuntary and forceful muscular movements occur, the tongue may be bitten, foam appears at the mouth. The patient stops breathing and becomes cyanotic; this stage lasts about one minute. The final stage is a more or less prolonged coma. When the patient awakens, she is unlikely to remember the event. In some rare cases there are no convulsions and the patient falls directly into a coma. Some patients when they awake from the coma may have temporary blindness.
- Chesley LC. Hypertensive Disorders in Pregnancy, in Williams Obstetrics, 14th Edition. Appleton Century Crofts, New York (1971), page 700.
- ACOG. "Diagnosis and Management of Preeclampsia and Eclampsia". ACOG Practice Bulletin # 33, 2002,.