Eclampsia: Symptoms, Emergency Treatment and Prevention
Table of Contents
Key takeaways
- Eclampsia is a medical emergency in pregnancy or shortly after birth, defined by seizures in the context of pre-eclampsia.
- Severe headache, visual changes, upper abdominal pain, sudden swelling, breathlessness or very high blood pressure need urgent assessment.
- Treatment usually involves hospital care, seizure prevention or control, blood pressure management and planning the safest timing of birth.
- There are no safe home remedies for eclampsia; delays can be dangerous for both mother and baby.
- Use NHS 111 for urgent advice or call 999 immediately for a seizure, collapse, severe breathlessness or life-threatening symptoms.
Overview
Eclampsia is a severe complication of pregnancy in which a woman or pregnant person has seizures related to pre-eclampsia. It can happen during pregnancy, during labour or after birth. Although it is uncommon, it is serious because it can affect the brain, liver, kidneys, lungs, blood clotting system, placenta and baby.
The word can sound similar to pre-eclampsia, but the two are not the same. Pre-eclampsia usually involves high blood pressure after 20 weeks of pregnancy with signs that organs or the placenta are under strain. Eclampsia is when seizures occur in that context. A seizure in pregnancy should always be treated as urgent until assessed by clinicians.
Good antenatal care reduces risk by detecting rising blood pressure, urine protein and symptoms early. Even so, eclampsia can develop quickly. The safest response is prompt hospital assessment and coordinated obstetric, midwifery, anaesthetic and neonatal care.
How eclampsia relates to pre-eclampsia
Pre-eclampsia is linked to abnormal placental development and blood vessel function. The placenta may release signals into the mother’s bloodstream that contribute to inflammation, blood vessel tightening and leakage, and changes in clotting. This can raise blood pressure and reduce blood flow to organs.
When the condition affects the brain, it can cause headache, visual disturbance, confusion, irritability, altered consciousness or seizures. Eclampsia may occur with obvious severe pre-eclampsia signs, but it can occasionally happen before pre-eclampsia has been recognised. That is why new neurological symptoms in pregnancy need careful attention.
Symptoms and warning signs
The defining symptom of eclampsia is a seizure. A seizure may involve loss of consciousness, stiffening, jerking movements, tongue biting, incontinence, confusion afterwards or reduced responsiveness. Any seizure in pregnancy or soon after birth needs emergency medical care.
Warning symptoms that may come before eclampsia include a severe or persistent headache, flashing lights or blurred vision, pain below the ribs or in the upper right abdomen, nausea or vomiting that feels unusual, sudden swelling of the face, hands or feet, shortness of breath, reduced urine output, chest pain, confusion or feeling very unwell.
Some swelling and discomfort can occur in normal pregnancy, but sudden or severe symptoms should not be dismissed. A person can have dangerous blood pressure without feeling severely ill, which is why routine antenatal blood pressure and urine checks are important.
Causes and risk factors
The precise cause is complex and not fully explained by one factor. Current understanding points to placental and blood vessel dysfunction, immune and inflammatory pathways, and maternal risk factors. The condition is not caused by stress, ordinary activity or something the pregnant person has done wrong.
Risk is higher in first pregnancies, previous pre-eclampsia, chronic high blood pressure, kidney disease, diabetes, autoimmune disease such as lupus or antiphospholipid syndrome, multiple pregnancy, assisted reproduction, age over 40, a body mass index in the obese range, family history of pre-eclampsia, or a long interval since the previous pregnancy.
Risk factors help clinicians plan monitoring, but eclampsia can still occur in people without obvious risk factors. Conversely, having a risk factor does not mean eclampsia will happen.
Diagnosis and monitoring
Assessment includes blood pressure measurement, urine testing and clinical review of symptoms. Blood tests may check platelets, liver function, kidney function and clotting. Fetal assessment may include measuring growth, ultrasound, Doppler studies and heart-rate monitoring depending on gestation and severity.
If a seizure has occurred, clinicians also consider other causes such as epilepsy, low blood sugar, stroke, brain infection, drug toxicity or trauma. However, when eclampsia is possible, treatment to protect the mother is urgent and may begin while investigations continue.
Monitoring is usually in hospital for suspected severe pre-eclampsia or eclampsia. This allows rapid blood pressure treatment, seizure prevention, fluid balance monitoring and planning for birth if needed.
Treatment and birth planning
Eclampsia treatment is emergency care, not home care. Magnesium sulphate is commonly used in hospital to treat and prevent eclamptic seizures. Blood pressure medicines may be given to reduce the risk of stroke and other complications. Oxygen, intravenous access, blood tests, catheter monitoring and close observation may be needed.
The only definitive way to end the pregnancy-related trigger is birth of the baby and placenta, but timing depends on gestation, maternal condition and fetal wellbeing. If the mother is unstable, urgent delivery may be needed. If the pregnancy is very preterm and the situation can be stabilised, clinicians may use medicines such as corticosteroids to support the baby’s lungs before planned birth, depending on timing and safety.
Mode of birth is individual. Some people can have an induced vaginal birth if stable and appropriate. Others need caesarean birth because of maternal or fetal urgency, gestation, presentation or obstetric factors. Suitability is confirmed after consultation with the maternity team.
Reducing risk
Prevention starts with early booking and regular antenatal care. Blood pressure checks and urine testing are simple but important screening tools. People at increased risk may be advised to take low-dose aspirin during pregnancy, according to NICE guidance and clinician assessment. Calcium supplementation may be relevant in populations with low dietary calcium intake, but this should be discussed with a healthcare professional.
Self-care supports general pregnancy health but cannot reliably prevent eclampsia. Useful steps include attending all appointments, reporting warning symptoms promptly, taking prescribed medicines, avoiding smoking, and asking for advice before using over-the-counter medicines, supplements or herbal products.
After birth and recovery
Pre-eclampsia and eclampsia can continue or first appear after birth, so monitoring does not stop immediately after delivery. Blood pressure may remain high for days or weeks and medication may be needed. Follow-up helps confirm recovery of blood pressure, kidney function, liver tests and symptoms.
People who have had pre-eclampsia or eclampsia have a higher chance of high blood pressure and cardiovascular disease later in life. A postnatal review should include future pregnancy planning, contraception discussion, blood pressure follow-up and advice on long-term heart health. Emotional recovery also matters; a seizure, emergency birth or neonatal admission can be frightening, and support should be offered.
Seek urgent help after birth for severe headache, visual symptoms, chest pain, breathlessness, upper abdominal pain, confusion, fainting, seizure, heavy bleeding or feeling seriously unwell. Call 999 for a seizure or life-threatening symptoms.
Sources
- NHS: Pre-eclampsia: https://www.nhs.uk/conditions/pre-eclampsia/
Relevance: UK patient guidance supporting symptoms, diagnosis, treatment and urgent warning advice for pre-eclampsia and eclampsia risk. - NICE: Hypertension in pregnancy diagnosis and management: https://www.nice.org.uk/guidance/ng133
Relevance: UK clinical guideline supporting blood pressure monitoring, aspirin prevention, hospital management and birth planning principles. - World Health Organization: Recommendations for prevention and treatment of pre-eclampsia and eclampsia: https://www.who.int/publications/i/item/9789241548335
Relevance: Global guideline supporting magnesium sulphate, antihypertensive treatment and prevention strategies. - PubMed: Pre-eclampsia and eclampsia review: https://pubmed.ncbi.nlm.nih.gov/28302727/
Relevance: Peer-reviewed review supporting pathophysiology, maternal complications and clinical management context.
Disclaimer
Educational only. Results vary. Not a cure.