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eclampsia(ĭklămp`sēə), term applied to toxic complications that can occur late in pregnancy. Toxemiatoxemia
, disease state caused by the presence in the blood of bacterial toxins or other harmful substances. The effects of the bacterial toxins known as endotoxins are relatively uniform, regardless of which bacterial species the toxin comes from, and are separate from the
..... Click the link for more information. of pregnancy occurs in 10% to 20% of pregnant women; symptoms include headache, vertigo, visual disturbances, vomiting, hypertension, and edema. The four categories of hypertension during pregnancy are pre-eclampsia, eclampsia, chronic hypertension, and transient hypertension. Pre-eclampsia, which occurs late in pregnancy, is characterized by decreased cardiac output and increased blood vessel resistance. It may be prevented with calcium supplements and low-dose aspirin, and a cesarian section is often safer than natural childbirth. Only 5% of of women with pre-eclampsia progress to eclampsia, which is accompanied by convulsions and coma. To avoid renal and cardiovascular damage of the mother and to prevent fetal damage, the condition is treated by termination of pregnancy.
a serious disease occurring during pregnancy, labor, or the postpartum period. Eclampsia is a late stage of toxemia of pregnancy. The condition is characterized by convulsions that develop in a definite sequence. Slight fibrillar contractions of the facial muscles (15–30 seconds) are followed by tonic spasms of the total skeletal musculature and loss of consciousness (15–20 seconds). Clonic muscular spasms of the trunk and limbs occur, and, finally, the woman lapses into a brief or prolonged coma. Consciousness returns gradually. In particularly severe cases, eclampsia may occur without convulsions (comatous forms). Eclampsia is often manifested by only a few convulsions, and high blood pressure may not be a symptom. Death may occur during or after convulsions as a result of pulmonary edema, hemorrhages into the brain, and asphyxia. The fetus often dies in utero from hypoxia. The prognosis depends on the number and duration of the convulsions or on the duration of the coma.
Current treatment of eclampsia is based on principles developed by the Soviet obstetrician-gynecologist V. V. Stroganov in 1928. Total physical and mental rest is prescribed. Functioning of the vital organs is restored: Drugs are administered to decrease the excitability of the central nervous system, to lower blood pressure, and to stimulate urination. Oxygen is administered in cases of pronounced hypoxia, and labor is induced quickly but cautiously. The patient should not be moved during convulsions or while in a coma. Prompt hospitalization is required as soon as consciousness is regained. Prophylaxis includes the prevention of advanced toxemia and prompt hospital treatment of neuropathy and preeclampsia.
REFERENCENikolaev, A. P. Pozdnie toksikozy beremennykh. Moscow, 1972.
A. P. KIRIUSHCHENKOV