Eclampsia - late form of preeclampsia, characterized by a sharp rise in blood pressure that threaten the life of the mother and fetus. Preeclampsia - disruption of pregnancy, manifested dysfunction of body systems. Eclampsia can occur before, during and after pregnancy.
Eclampsia: Causes of the disease
Eclampsia is the most severe form of preeclampsia, characterized by disruption of the central nervous system and at untimely reliever - coma and death of the mother and fetus. Currently, there is no consensus on the causes of eclampsia. Eclampsia is not an independent disease, but a complex of combined forms of preeclampsia. There are about 30 theories of the state, among which also secrete viral nature of the violation.
Among the main causes of eclamptic states allocate:
- Defects in genes;
To date, there is no single test that can reliably predict the development of eclampsia during pregnancy. Eclampsia generally develops after 22 weeks of pregnancy, due to fetal development. Until then, the fetus is incapable of surviving outside the womb because of the incomplete formation of the higher brain structures. At week 22 in the fetus first appear neurospecific protein compounds which, when penetrating through the damaged placenta cause systemic immune inflammation characterized by vasospasm. It explains the background to the development of eclampsia placental insufficiency (a condition caused by the dysfunction of the placenta).
Condition precedes eclampsia pre-eclampsia, which is characterized by high blood pressure, presence of protein in the blood, nausea, headache, disturbance of reflexes. Preeclampsia requires medical monitoring and timely correction of symptoms. The only effective treatment for eclampsia is delivery.
Eclampsia is a specific brain damage when preeclampsia occurs at a time when:
- The critical reduction of cerebral blood flow;
- Cerebral ischemia;
- Loss of self-regulation of cerebral circulation;
- Cytotoxic brain edema;
- Violation of the cellular ion hemostasis functioning of the structures of the brain, the release of toxic neurotransmitters and stress genes that provoke the onset of unconsciousness, convulsions, coma pregnant.
These factors explain the features of eclampsia:
- The rarity of occurrence (the state shown in only 5% of pregnant women);
- Blazing development of symptoms and the critical state of pregnancy.
Algorithm Development eclampsia following:
- Long preeclampsia (often characterized by severe);
- Preeclampsia (optional step);
- Transient loss of consciousness;
- Tonic, clonic convulsions;
- Convalescence (after delivery).
In some cases, eclampsia can have very serious consequences, as the coma, functional failure of kidney, liver, lung, or in extreme cases - death of the brain. During eclamptic seizures can develop fetal hypoxia and death.
Eclampsia pregnancy: risk factors
There are certain risk factors for eclampsia pregnant women, among which are:
- Early, as well as late (after 40 years) the first pregnancy;
- Eclampsia is a family history;
- Multiple pregnancies;
- Chronic diseases (diabetes, hypertension, kidney disease and cardiovascular systems, antiphospholipid syndrome);
- The time interval between births of 10 years or more.
There are also a number of factors causing the development of eclampsia during pregnancy:
- Impaired uterine blood flow;
- Violation of water-salt balance of the body of a pregnant.
Postpartum eclampsia: the likelihood of developing
The likelihood of developing eclampsia in pregnancy is:
- During pregnancy - from 67 to 75%;
- At birth - 25%;
- In the postpartum period - 1-2%.
Typically, postpartum eclampsia develops within the first 48 hours after birth, after this period, the risk of states is minimal. Postpartum eclamptic condition is caused by hemodynamic, metabolic, hypoxic disorders of the body during gestation. Symptoms of postpartum eclampsia symptom similar to the prenatal and birth eclampsia. Also offensive postpartum eclampsia may be caused by shock and pain by external factors (bright light, loud noise).
Symptoms of eclampsia
The main symptoms of eclampsia include:
- Small muscle contraction;
- Tonic muscle spasms of skeletal muscles;
- Clonic spasms of muscles of the trunk;
- Transient loss of consciousness;
- Cyanosis (bluish skin and mucous membranes);
- Eclamptic coma.
Others symptoms of eclampsia are also irregular breathing (apnea development), frothing at the mouth, often mixed with blood.
Signs of an approaching fit eclampsia are:
- Increased drowsiness, weakness;
- Nausea, vomiting, uncontrolled, not due to other reasons;
- Increased blood pressure;
- Violations of visual function (blurred vision, "flies" in front of the eyes);
- Proteinuria (the presence of protein in the urine).
Eclampsia can be shown as one long stroke, and a number of short episodes.
The treatment of eclampsia: forecasts and methods
Forecast for treatment of eclampsia by a number of the following factors:
- The severity of the condition of the pregnant woman (pronounced swelling, composition of urine, blood pressure);
- The frequency of occurrence of seizures, their severity;
- Timely assistance and cupping;
- Complications caused by the attacks.
If you suspect eclampsia in pregnant conducted constant monitoring of blood pressure, maternal and fetal hemodynamics. Patients show salt-free diet.
Stopping seizures, increased discharge of urine is a good sign, which will postpone the need for immediate delivery.
An increase in temperature, arrhythmia, sudden drop in blood pressure after hypertension is an indication for immediate delivery.
The main treatment of eclampsia is to facilitate the symptomatic complex:
- Relief seizure and removal of vascular spasm;
- Normalization of pressure;
- Blood oxygenation;
- Dehydration therapy, promoting increased urination and reduce swelling.
When eclamptic fit is used intensive therapy, which has the character of cardiopulmonary resuscitation in combination with therapy aimed at restoring brain function that can prevent repeated attacks.
The decision on delivery is taken depending on the severity of preeclampsia and the condition of the patient at the time of eclamptic fits.