Eclampsia

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Eclampsia Treatment

Because the risk of eclampsia is unpredictable and often not easily correlated to physical signs, such as the degree of hypertension or proteinuria, an anticonvulsant (seizure prevention medication) is usually given to women in labor with pre-eclampsia. Magnesium sulfate is a safe drug for both the mother and the fetus when used to prevent seizures.

The treatment of women with pre-eclampsia is bedrest and delivery as soon as viable for the fetus. Patients are usually hospitalized, but occasionally may be managed on an outpatient basis with careful monitoring of blood pressure, urine checks for protein, and weight.

Medication may be used to lower the elevated blood pressures. Optimally, the condition is managed until delivery after 36 weeks can occur.

Delivery may be induced if any of the following occur:

• diastolic blood pressure of greater than 110 mmHg consistently for a 6-hour period
• persistent and/or severe headache
• epigastric (stomach region) pain
• abnormal liver function tests
• rising serum creatinine
• HELLP syndrome
• pulmonary edema (fluid in lungs)
• eclampsia
• thrombocytopenia
• abnormal fetal heart pattern
• failure of fetal growth noted by ultrasound

Delivery is the treatment of choice for eclampsia in a pregnancy over 28 weeks. For pregnancies less than 24 weeks, the induction of labor is recommended, although the likelihood of a viable fetus is minimal.

Prolonging such pregnancies results in maternal complications as well as infant death in approximately 87% of the cases. Pregnancies between 24 and 28 weeks gestation present a "gray zone," and conservative management may be attempted, with monitoring for the presentation of maternal and fetal complications.