High-blood-pressure-related pregnancy and postpartum complications like preeclampsia and eclampsia have been on the rise in the U.S. in recent decades. These health issues can cause serious and even life-threatening problems for mothers and babies. But when caught early, they’re highly manageable.
Here’s what every mom-to-be should know about eclampsia, its relationship to preeclampsia, and what you can do to protect your health.
What is eclampsia?
Eclampsia is a rare but life-threatening condition marked by the development of seizures during or shortly after pregnancy.
Eclampsia during pregnancy typically arises from unresolved preeclampsia, a pregnancy complication characterized by high blood pressure, swelling and protein in the urine.
About one-third of all preeclampsia symptoms happen during the postpartum period, making it all the more important for women, their families and their practitioners to be vigilant and know the signs even after delivery.
What are the symptoms of eclampsia?
Seizures, loss of consciousness and/or severe agitation — usually close to or during delivery — are the most common symptoms of eclampsia. Postpartum seizures can also occur, usually within the first 48 hours after delivery.
But eclampsia-related seizures generally don’t come out of nowhere. Before having a seizure caused by eclampsia, most women experience other signs like:
Severe headaches
Nausea or vomiting
Stomach pain
Hand or facial swelling
Double vision, blurred vision, vision loss or missing areas in the visual field
How does eclampsia differ from preeclampsia?
Eclampsia can develop when preeclampsia, a condition characterized by a sudden spike in blood pressure during pregnancy or shortly after giving birth, goes untreated.
If preeclampsia isn’t properly caught, diagnosed and managed, it can get worse over time and turn into eclampsia, which can cause a pregnant or postpartum woman to experience seizures and/or lose consciousness. In the most severe cases, eclampsia can lead to a pregnant or recently pregnant woman to lapse into a coma.
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The idea of eclampsia can be scary to think about. But it’s important to keep in mind that this complication is very rare. While 5 to 8 percent of pregnant women in the U.S. are diagnosed with preeclampsia, most cases can be treated before they turn into eclampsia.
Who is most at risk for eclampsia?
Women with preeclampsia can potentially develop eclampsia. Your risk of being diagnosed with preeclampsia and eclampsia is higher if you:
Are over 35. Older moms-to-be are at higher risk for pregnancy complications in general.
Are Black. Preeclampsia and eclampsia are among the pregnancy complications more likely to affect Black women. In fact, Black women are 60 percent more likely to develop preeclampsia or eclampsia compared to white women.
Are diabetic, have high blood pressure, suffer from kidney disease, or have an autoimmune disease like lupus. These conditions can damage blood vessels and organs and make preeclampsia or eclampsia more likely.
Are obese. Obesity is associated with an increased risk of high blood pressure and pregnancy complications.
Have a history of preeclampsia or pregnancy complications. If you or a family member has experienced preeclampsia or eclampsia before, or if you've had other complications during a prior pregnancy, you may be at higher risk.
Are pregnant with multiples. Being pregnant with twins, triplets or other multiples increases the chances for pregnancy risks and complications, including preeclampsia and, if it's left untreated, eclampsia.
Have closely spaced or far apart pregnancies. Women with pregnancies fewer than two years apart or more than 10 years apart seem to be at higher risk.
Got pregnant with infertility treatments like IVF. IVF has been linked to a higher risk of preeclampsia, though modified natural IVF cycles seem to have a lower risk than programmed cycles, some research shows.
What causes eclampsia?
Researchers are still finding clues as to the precise causes of preeclampsia and eclampsia, but as of yet, no one has been able to pin down one specific explanation for the two pregnancy complications. Factors that are thought to potentially play a role include:
Blood vessel problems
Problems related to the brain or nervous system
Genetic factors
Placental abnormalities like insufficient blood flow
Environmental exposures
Cardiovascular changes or inflammation
Hormonal imbalances
Maternal diet
Certain autoimmune disorders
How is eclampsia diagnosed?
Eclampsia is typically diagnosed through blood or urine tests and by taking a woman's blood pressure. If a woman who is pregnant or has recently given birth experiences symptoms like a seizure or coma, her provider would perform those tests.
Experts don’t know which women with preeclampsia will go on to develop eclampsia. But eclampsia seems to be more common in women who have severe preeclampsia symptoms like very high blood pressure, headaches, abdominal pain, or changes in their vision. These women might also show abnormal blood test results before the onset of their seizures.
How is eclampsia treated?
Eclampsia is a life-threatening emergency that needs to be treated immediately in order to stop the seizures and bring a woman’s blood pressure down, as well as protect her baby. Treatment typically involves:
Anti-seizure medications. Magnesium sulfate, a mineral compound, may be given to stop a seizure while it’s happening and keep future ones from developing.
Blood pressure medications. Antihypertensive medications can help bring down a woman’s blood pressure.
Delivery of the baby. Letting the pregnancy continue can be harmful to both a woman and her baby, even if her due date is still far off.
What are the complications of eclampsia?
While eclampsia is rare, it can lead to life-threatening problems for mothers and babies when left untreated. These can include:
Stroke, kidney failure or other organ damage. Unresolved high blood pressure can cause strokes and possible kidney, liver, brain, heart and lung problems in women.
HELLP syndrome. This syndrome occurs in 1 to 2 in 1,000 pregnancies. Among women with severe preeclampsia or eclampsia, the number is higher, appearing in between 10 to 20 percent of pregnancies.
Premature birth. Stopping preeclampsia or eclampsia often means delivering right away, even if it means the baby will be premature.
Poor fetal growth. Preeclampsia and eclampsia can make it harder for a growing baby-to-be to get the oxygen and nutrients she needs, which can restrict growth.
Placental abruption. This rare but serious complication happens when the placenta detaches from the uterine wall before delivery, which can potentially cause heavy bleeding or fetal distress, or increase the chances for stillbirth.
What you can do to prevent eclampsia
Experts can’t predict which women with preeclampsia will go on to develop eclampsia. Being proactive about your health, knowing the signs of both conditions, and seeking medical attention right away if you think something might be wrong can help both you and your baby.
Follow these tips for reducing your chances of eclampsia and preeclampsia:
Going to your prenatal visits. Regular checkups with your practitioner will allow the doctor to pick up on any of the symptoms of preeclampsia. If you are diagnosed with preeclampsia, your practitioner will keep a close eye on you (and your blood pressure) to make sure your condition doesn't progress to eclampsia.
Taking low-dose or baby aspirin if recommended by your doctor. Women at high risk for preeclampsia should take 81 mg aspirin daily as a preventive measure starting at 12 to 28 weeks until they deliver, recommends the American College of Obstetricians and Gynecologists (ACOG). Always talk with your doctor before starting any kind of medication or supplement when you’re pregnant.
Know the warning signs. Both preeclampsia and eclampsia can be life-threatening. Let your provider know right away if you experience late-pregnancy warning symptoms like severe headache, upper abdominal pain especially on your right side, nausea or vomiting, shortness of breath, decreased urine output, or swelling of the face or hands. Call 911 if you experience vision changes or think you might be having a seizure.
Eating right and staying active. Eating a healthy diet and exercising regularly haven’t been tied to a lower risk of preeclampsia or eclampsia specifically. But it’s a great way to feel your best and stay healthy during your pregnancy.
As for remedies you might have heard about, like taking vitamins C or E, eating a low salt diet or supplementing with fish oil? For now, there’s not enough evidence to show that any of those things are beneficial. If you’re still considering trying them, talk with your doctor first.
Thinking about serious pregnancy conditions like eclampsia can be unsettling. Thankfully, it’s possible to catch many women when they’re still pre-eclamptic, before the most serious complications set in. And with optimum treatment and careful follow-up, the majority of women with eclampsia return to normal health after delivery.
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