Pregnancy: Preeclampsia and Eclampsia

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

How are preeclampsia and eclampsia diagnosed?

Preeclampsia may be diagnosed at a regular pregnancy health screening. Protein in the urine is diagnosed by a urinalysis, and blood pressure measurements taken in the clinic may show elevated values. Blood pressure in preeclampsia is usually over 140/90. Blood tests, such as blood cell counts and tests for blood clotting ability, will also be done. Recent research has shown that Congo red (CR) spotting tests may be better indicators of preeclampsia than standard urine dipstick tests for proteinuria. The test is based on the fact that the urine and placentas of women with preeclampsia contain abnormally folded proteins that bind to the Congo red stain. Since preeclampsia may be asymptomatic (produce no symptoms), it is important for pregnant women to have routine health checkups. Tests to monitor the health of mother and baby will also be ordered.

There are no predictive tests to show whether or not a woman will develop preeclampsia.

What is the treatment for preeclampsia and eclampsia?

There is no cure for preeclampsia and eclampsia other than delivery of the baby. The decision about whether to induce labor or perform a Cesarean section depends upon the severity of the condition, as well as the gestational age and health of the fetus.

Women with mild preeclampsia are often induced at 37 weeks' gestation. Prior to this time, they can be managed at home or in the hospital with close monitoring. During this time steroid drugs may be given to promote maturation of the baby's lungs. Women with mild preeclampsia prior to 37 weeks' gestation are often prescribed bed rest with frequent medical monitoring.

In severe preeclampsia, delivery (induction of labor or Cesarean delivery or C-section) is usually considered after 34 weeks of gestation. The risks to the mother and baby from the disease must be balanced against the risk of prematurity in this case. Intravenous magnesium sulfate can be given to women with severe preeclampsia to prevent seizures. This medication is safe for the baby. Oral supplements containing magnesium are not effective in preventing seizures and are not recommended. Medications such as hydralazine to lower blood pressure may also be given.

Eclampsia is a medical emergency. It is treated with medications to control seizures and maintain a stable blood pressure with the goal of minimizing complications for both mother and baby. Magnesium sulfate is used as a first-line treatment when eclamptic seizures do occur. If the seizures are not controlled by magnesium sulfate, other medications such as lorazepam (Ativan) and phenytoin (Dilantin, Dilantin-125) can be administered.

Medically Reviewed by a Doctor on 11/12/2015

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