What is eclampsia?
Pre-eclampsia gets its name from the fact that, it is the condition which precedes eclampsia. Historically, eclampsia was an issue because, with less than perfect antenatal care, this was sadly a common culmination of this syndrome. Nowadays, it is not uncommon for a doctor to go through training and practice to retirement without seeing a case of eclampsia.
Basically, eclampsia is generalised convulsions or seizures with loss of consciousness, indistinguishable from an epileptic seizure. It is the ultimate complication of pre-eclampsia. All measures instituted in pre-eclampsia are geared towards preventing this from happening.
Will delivery prevent eclampsia?
Not always. Delivery is certainly the beginning of the end of pre-eclampsia. There is, however, a critical period of about 48 to 72 hours following delivery in severe pre-eclampsia, where eclampsia might still happen. That is why intensive monitoring of the condition continues unabated in this immediate post-delivery period.
Eclamptic fits have been reported to occur up to seven days after delivery, but this is so rare that it can be safely discounted.
Occasionally, anti-hypertensive medication may need to be continued for several weeks after delivery to control the blood pressure. The risk of eclampsia, however, recedes rapidly after delivery and virtually disappears after the first four days. Other potential complications of raised blood pressure, such as stroke, remain hence the need to ensure well-controlled blood pressure.
Will the pre-eclampsia recur in the next pregnancy?
The odds are that it will not. If this was the mother's first pregnancy, she has a roughly one in four (25 per cent) chance of having the condition in her subsequent pregnancy. If she was affected in her second or later pregnancy, the risk is higher, up to one in two, i.e. 50 per cent.
In a small group of patients, pre-eclampsia recurs in every pregnancy. These women are considered to have an underlying latent essential hypertension.
What are the affected mother's chances of developing chronic hypertension later on in life?
For the majority of women who suffer from pre-eclampsia in one pregnancy (usually the first), the risk is similar to that of the general population, i.e. it is not increased. The story is different for those who experience recurrent pre-eclampsia in each pregnancy. Here, as mentioned before, the risk of chronic hypertension later on in life is significantly above average.
Recurrent pre-eclampsia is therefore regarded as a sign of latent hypertension.
Can one do anything to prevent pre-eclampsia?
No. Medical science as it stands now does not offer any measures to stop pre-eclampsia from developing.
Are there any factors that increase the risk of pre-eclampsia developing in pregnancy?
Yes, but most will be out of the mother's control. These include:
Chronic renal disease
There is no evidence that good diabetes control reduces the risk of pre-eclampsia.
What about drug abuse and pre-eclampsia?
Drug abuse, especially with cocaine has been associated with hypertension and increased risk of placental abruption and fetal loss. It has not been associated with pre-eclampsia.
On the other hand, those who abuse heroin are not advised to withdraw during pregnancy. Instead, a switch to a better controlled agent in the form of methadone is advised. This is because heroin withdrawal can cause a significant rise in blood pressure. Neither use nor withdrawal is associated with pre-eclampsia.
Can pre-eclampsia cause fetal malformations or abnormalities?
How safe is the oral contraceptive pill after suffering from pre-eclampsia?
Very safe. Once the blood pressure has settled, which may be within two or three weeks of delivery (but occasionally longer) and in the absence of contraindications to its use, the pill can be safely taken.
Last update: February 11, 2013