Eclampsia-an obstetrical emergency

Pre-eclampsia, which precedes eclampsia, is characterized by high arterial blood pressure ( Hypertension) in a pregnant woman.The high B.P. is just a symptom of a severe systemic disease which may involve damage to the liver, the kidney and the brain blood vessels. Kidney tissue is shed as protein in urine.There is swelling ,especially of the hands, feet and face partly due to the inability of the kidney to function adequately.The onset of these symptoms is at about the 20th week of pregnancy and symptoms may last for weeks after child birth. Eclampsia is more severe and is characterized by fits and coma.


Women who have had pre-existing high B.P.,diabetes, kidney disease and blood clotting disorders, are more at risk of toxemia of pregnancy( pre-eclamsia and eclampsia). Eclampsia and pre-eclampsia usually occur in first pregancies and multiple pregnancies. A history of pre-(eclampsia) is enough worry to expect future pre-(eclampsia) .It is now believed that the pregnant woman may not have had time to develop tolerance to the genetic material(which is antigenic) of the father passed to the fetus and so her immune system reacts to the fetus through damage to her own tissues, including the placenta and this can lead to rejection of the fetus in miscarriage. As a result a shallowly implanted placenta leads to ischemia and this promotes damage to maternal tissues through the release of inflammatory mediators. A large placenta or hydatidiform mole, will release more of these mediators, and is more likely to elicit (pre-)eclampsia.


Pre-eclampsia can be managed by reducing high B.P. and the weight of the pregnant woman. Since it gives rise to a systemic multi-organ failure, the heart, kidney, liver and clotting should be adequately monitored prior to delivery; usually by cesarean section, unless labor is already at advanced stage. Fits of eclampsia are controlled by conservatively treating with magnesium sulfate.


Dutch researchers have advanced that the woman should be exposed to semen, containing the sperm of her spouse through frequent sexual contact so as to develop tolerance to paternal material, as a preventive measure.


Dr. Oliver Verbe Birnso

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