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Eclampsia

Eclampsia is a serious complication of pregnancy and is characterised by convulsions. Usually eclampsia occurs after the onset of pre-eclampsia though sometimes no pre-eclamptic symptoms are recognisable. The convulsions may appear before, during or after labour, though cases of eclampsia after just 20 weeks of pregnancy have been recorded. more...

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Signs and symptoms

The majority of cases are heralded by pregnancy-induced hypertension and proteinuria but the only true sign of eclampsia is an eclamptic convulsion, of which there are four stages. Patients with edema and oliguria may develop renal failure or pulmonary oedema.

  • Premonitory stage - this stage is usually missed unless constantly monitored, the woman rolls her eyes while her facial and hand muscles twitch slightly.
  • Tonic stage - soon after the premonitory stage the twitching turns into clenching. Sometimes the woman may bite her tongue as she clenches her teeth, while the arms and legs go rigid. The respiratory muscles also spasm, causing the woman to stop breathing. This stage continues for around 30 seconds.
  • Clonic stage - the spasm stops but the muscles start to jerk violently. Frothy, slightly bloodied saliva appears on the lips and can sometimes be inhaled. After around two minutes the convulsions stop, leading into a coma, but some cases lead to heart failure.
  • Comatose stage - the woman falls deeply unconscious, breathing noisily. This can last only a few minutes or may persist for hours.

Epidemiology

It can be fatal to both mother and fetus, with just under one in 50 women dying and one in 14 of their babies also not surviving, despite best-available medical care.

Bibliography

  • Mayes, M., Sweet, B. R. & Tiran, D. (1997). Mayes' Midwifery - A Textbook for Midwives 12th Edition, pp. 533–545. Baillière Tindall. ISBN 0-7020-1757-4

Read more at Wikipedia.org


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Morbidity rose during 4-year period: eclampsia tops list of severe maternal morbidities
From OB/GYN News, 9/15/04 by Heidi Splete

SALT LAKE CITY -- For every 1,000 deliveries in the United States between 1991 and 2000, 4.6 women experienced severe morbidity, Dr. William M. Callaghan said at the annual meeting of the Society for Pediatric and Perinatal Epidemiologic Research.

Even relatively uncommon complications of pregnancy will impact large numbers of women, and hospitals should know where to focus their attention concerning these issues, said Dr. Callaghan of the Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta.

He used data from the National Hospital Discharge Survey to examine ICD-9 codes and identify women who likely had severe morbidity during or shortly after delivery.

The severe morbidity rate was based on a 3-day hospital stay, which was above the median length of stay for a pregnancy.

On examination of approximately 318,000 records, it was found that nearly 1,500 women experienced severe morbidity.

Of these, almost 17% had a code for eclampsia.

Respiratory failure, sepsis, renal failure, and cardiac arrest were among other causes of severe morbidity. In addition, nearly half of the women received transfusions, although the transfusion may have been as little as one unit of blood. Dr. Callaghan noted during the meeting.

Older women, black women, and women with other than private insurance had a higher incidence of morbidity than their counterparts, as did women who delivered later in the decade.

The incidence of severe morbidity increased gradually during the last 4 years of the study, however, the reason for this increase was unclear, according to Dr. Callaghan.

He suggested that hospitals should use discharge codes to monitor severe morbidity, despite some limitations, as a way to review what types of services are being used and how to improve them.

"Identification and review of women with severe morbidity has potential to provide insight into opportunities for prevention along the continuum of morbidity." Dr. Callaghansaid.

BY HEIDI SPLETE

Senior Writer

COPYRIGHT 2004 International Medical News Group
COPYRIGHT 2004 Gale Group

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