Éclampsie

Abstract

Eclampsia, the major neurological complication of preeclampsia, is defined as a convulsive episode, or any other sign of an altered consciousness, arising in a setting of preeclampsia, and which cannot be attributed to any other preexisting neurological condition. Convulsive episodes have been described up to 15 days post-partum. Visual disturbances (cortical blindness) are common and must be considered as the equivalent of a convulsive crisis. In case of doubt, the gold standard investigation is the performing of a diffusion weighted MRI. The management of women suffering a convulsive episode is the same as in any other generalized tonic-clonic seizure. Magnesium sulfate as a loading dose followed by a continuous infusion is the most effective way for preventing a relapse associated with blood-pressure normalization. Magnesium sulfate infusion must be maintained for 24 hours following the last convulsive episode.

Thinking Outside the Box

“…Nevertheless, the curative approach is prompt delivery. This condition is associated with high morbidity and mortality of both the mother and fetus, so a quick and proper diagnosis is critical [3,4].…”

Impact of extreme maternal age on neonatal outcomes

“…Eclampsia, a major neurological complication of preeclampsia, affected adolescents more as reported by other authors. 22,23 The link between arterial hypertension and perinatal asphyxia could be explained biologically by uteroplacental insufficiency leading to a reduction in blood flow, loss of placental integrity and damage to endothelial cells which may predispose the fetus to growth retardation and perinatal anoxia. 23 In addition to vascular changes, seizures during eclampsia and anticonvulsant drugs could also contribute to a lower Apgar score at birth.…”

Modulation of preeclampsia by the cholinergic anti-inflammatory pathway: Therapeutic perspectives

“…Persistent arterial hypertension (systolic blood pressure, SBP ≥ 160 mmHg or DBP ≥ 110 mmHg) or severe maternal organic perturbations (renal, hepatic, hematologic or cardiorespiratory dysfunction) characterize the presence of severe PE [45]. Besides, eclampsia takes place when pregnant preeclamptic women develop generalized motor seizures which might not be attributed to a coexisting neurological disorder [46]. Multiple serious complications can be generated in preeclamptic women demanding careful assessment and management by healthcare professionals.…”