Eclampsia

Incidence varies from 0.01–0.1% of pregnancies in developed countries.

Occurs in 1–3% of pts with preeclampsia.

Risk factors include age <20 y old, nulliparity, anemia, diabetes, and preexisting heart disease.

Eclampsia is a factor in approximately 10% of all maternal deaths in developed countries.

Maternal complications include adult respiratory distress syndrome, acute renal failure, cardiopulmonary arrest, and CVA.

Fetal complications include respiratory distress syndrome, small for gestational age, preterm birth, and intrauterine growth restriction.

Risk of pulm aspiration and hypoxemia with seizure

Fetal bradycardia may occur during or following seizure

90% of women with eclampsia have manifestations of severe preeclampsia (Htn, proteinuria, renal insufficiency, pulmonary edema, coagulopathy)

New onset of generalized, tonic-clonic seizures, and/or unexplained coma during the peripartum period in a woman without a preexisting neurologic disorder.

Eclamptic seizures can occur during the antepartum (60%), intrapartum (20%), or postpartum (20%) period.

Onset of eclampsia is generally preceded by signs of severe preeclampsia but approximately 10% occur without Htn.