Eclampsia (cont.)

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The most common symptom of eclampsia is seizures, or convulsions. Similar to preeclampsia, other changes and symptoms may be present and vary according to the organ system or systems that are involved. These changes can affect the mother, the baby, or more commonly both mother and baby together. Some of these following symptoms may be perceived by the pregnant woman, but, more commonly, she is unaware that she has this disease:

• The most common sign of preeclampsia is elevated blood pressure and is also found in eclampsia. Again, the patient may be unaware that she is hypertensive.
• Blood pressure may be only minimally elevated, or it can be dangerously high. The degree of blood pressure elevation varies from woman to woman, and also varies during the progression and resolution of the disease process. Some women never have significant blood pressure elevation (including approximately 20% of women with eclampsia).
• A common belief is that the risk of eclampsia rises as blood pressure increases above 160/110 mm Hg.
• The kidneys may be unable to filter the blood efficiently. There may also be an abnormal excretion of protein in the urine. The first sign of excess urinary protein is usually determined on a urine specimen obtained at the time of a routine prenatal visit. It is unusual for a patient to experience symptoms related to excess urinary protein loss. In rare cases there may be excretion of a large amount of urinary protein.
• Nervous system changes can include blurred vision, seeing spots, severe headaches, convulsions, and, occasionally, blindness. Any of these symptoms require immediate medical attention, preferably at a hospital which provides obstetrical care, as the emergent delivery of the infant may be required.
• Changes that affect the liver can cause pain in the upper abdomen. This pain may be confused with the pain of indigestion or gall bladder disease. Other more subtle changes that affect the liver can alter platelet function, thus compromising the ability of the blood to clot. Excess bruising may be a sign of impaired platelet activity.
• The hypertension that is characteristic of preeclampsia can diminish placental blood flow, thus impairing fetal development. As a result, the baby may not grow properly and may be smaller than anticipated. In severe cases, fetal movements may be lessened as a result of impaired oxygenation of the fetus. A patient should call her physician immediately if she notices a marked decrease in fetal movement.

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