On convulsions during pregnancy

It is also one of the leading causes of maternal mortality in Nigeria. In medical terms, it is called eclimpsia. Dr. Nathaniel Adewole, Consultant Obstetrician and Gynaecologist, University of Abuja Teaching Hospital, say “eclampsia is convulsion before, during or immediately after pregnancy by a woman who is not known to have convulsive illness before. It […]

It is also one of the leading causes of maternal mortality in Nigeria. In medical terms, it is called eclimpsia. Dr. Nathaniel Adewole, Consultant Obstetrician and Gynaecologist, University of Abuja Teaching Hospital, say “eclampsia is convulsion before, during or immediately after pregnancy by a woman who is not known to have convulsive illness before. It is usually due to high blood pressure.” About one in every 100 women with pre-eclampsia develop eclampsia. So, most women with pre-eclampsia do not progress to have eclampsia. However, the main aim of treatment and care of women with pre-eclampsia is to prevent eclampsia and other possible complications.

About 20 to 28 per cent of women who die during pregnancy are as a result of pre-eclampsia. Dr. Adewole says eclampsia is risky because some women who appear to have normal blood pressure may develop this problem during pregnancy.

Hence, “if a woman who is pregnant suddenly develops headache, the woman should check her blood pressure. Also, that pain in the upper part of the abdomen should not be regarded as ulcer especially in pregnant women as it could be a symptom. Blurring of vision or other visual problems is also a sign of eclampsia. Again, when a woman suddenly discovers that she is becoming dizzy, or hearing voices like hallucinating, it may also be a sign of eclampsia,” Dr. Adewole warned.

Regular checks may be all that is needed if pre-eclampsia remains relatively mild. If pre-eclampsia becomes worse, you are likely to be admitted in hospital. Tests may be done to check on the well-being of he woman and that of the baby. For example, blood tests to check the function of the liver and kidneys. Also, an ultrasound scan is done to see how well the baby is growing.

Dr. Adewole says if the woman has already convulsed, then every injurious object should be taken away from her. Then the airway should be taken care of so that she can breathe well, nor bite her tongue. Eclampsia is preventable and can be avoided. In developed countries women do not die from eclampsia anymore.

Who gets pre-eclampsia?

Any pregnant woman can develop pre-eclampsia. It occurs in about one in every 14 pregnancies. However there is increased risk of developing pre-eclampsia if a woman is having her first pregnancy, it could be from a new partner. About one in every 30 women developes pre-eclampsia in their first pregnancy. This, Dr. Adewole says, is because the woman is beingt exposed to her husband’s antigen for the first time. And there is usually immune reaction for people who are meeting for the first time.  Also, women who had high blood pressure before the pregnancy started are at high risk.

Though the cause of pre-eclampsia is not known, some medical experts say it is probably due to a problem with the placenta (afterbirth). It is thought that the blood vessels in the placenta do not develop properly. This may affect the transfer of oxygen and nutrients to the baby.

How is pre-eclampsia detected?

Pre-eclampsia can develop anytime after 20 weeks of pregnancy. Pre-eclampsia is present if:

• Blood pressure becomes high and;

• If there is an abnormal amount of protein in the urine.

Is pre-eclampsia the same as high blood pressure in pregnancy?

Medical experts say No. Most do not have pre-eclampsia. With pre-eclampsia there is high blood pressure, plus protein in the urine and sometimes, other symptoms and complications listed below. According to experts, about one in five pregnant women with high blood pressure progress to pre-eclampsia

What is the treatment for pre-eclampsia?

The only complete cure is to deliver the baby. At delivery, the placenta (often called the afterbirth), is delivered just after the baby. Therefore, the cause of the condition is removed. After the birth, the blood pressure and any other symptoms in the mother usually soon settle.

It is common practise to induce labour if pre-eclampsia occurs late in the pregnancy. A caesarean section can be done if necessary. However, a difficult decision may have to be taken if pre-eclampsia occurs earlier in the pregnancy.

Dr. Adewole says magnesium sulphate has been very helpful in the treatment of pre-eclampsia. Studies have shown that if mothers with pre-eclampsia are given magnesium sulphate, it roughly halves the risk of developing eclampsia. Magnesium sulphate is an anticonvulsant, but prevents eclampsia much better than other types of anticonvulsants which are used for epilepsy. It does not affect the outcome of the baby; also the risk of serious consequences to the mother is much reduced.