Definition of Eclampsia
     New onset of grand mal seizure activity 
           and/or unexplained coma during 
  pregnancy or postpartum in a woman with 
         signs or symptoms of preeclampsia
        It typically occurs at ≥ 20th week of 
                              gestation.
           It is considered a complication of severe 
     NPC Training in MNH     preeclampsia.
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                      Prevalence
    • 10% of all pregnancies are complicated 
      by hypertension. 
    • Eclampsia and preeclampsia account for 
      about half of these cases worldwide.
    • Preeclampsia affects approximately 4.5 
      to 11.2% of pregnancies in 
      industrialized countries [ 33]
   NPC Training in MNH                                  3
                      Presentation
    • Seizure or postictal state (100%)
        –tonic-clonic spasms like epilepsy
    • Headache (83%), usually frontal
    • Vision disturbance (44%), such as blurred 
       vision and photophobia
        –Nurse patient in a darkened room
    • Amnesia and other mental status changes
    • Coma (unconsciousness)
  NPC Training in MNH                                       4
                      Presentation cont.
     Physical signs                      Physical signs cont.
     1. Sustained systolic BP greater    9.  Oliguria or anuria
         than 160 mm Hg or diastolic     10. Localizing neurologic deficits
         BP greater than 110 mm Hg       11. Right upper quadrant or 
     2. Tachycardia                          epigastric abdominal 
     3. Tachypnea                            tenderness with nausea (20%)
     4. Rales                            12. Generalized oedema  (49%)
     5. Hyperreflexia (80%)              13. Small fundal height for the 
                                             estimated gestational age
     6. Clonus                           14. Apprehension
     7. Papilledema                      15. Marked proteinuria
    NPC Training in MNH                                                  5
                           Aetiology
    1. Genetic predisposition,       7. Vascular endothelial 
    2. Immunology,                       damage,
    3. Endocrinology,                8. Cardiovascular 
    4. Nutrition,                        maladaptation, 
    5. Abnormal trophoblastic        9. Dietary deficiencies or 
        invasion,                        excess, and infection 
    6. Coagulation                       have been proposed as 
        abnormalities,                   etiologic factors for 
                                         preeclampsia/eclampsia
                                         [2] 
    NPC Training in MNH                                            6