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Eclampsia is one of the most serious complications which may occur during pregnancy. It is a condition of profound poisoning of the mother's system characterised by repeated fits, each fit being followed by a varying period of unconsciousness. The disease, which is not common, never occurs in the early months of pregnancy, the earliest cases reported having developed during the fifth month of gestation ; it may, however, actually arise during labour, or in the first few days of the lying-in period. It is more likely to occur during a first pregnancy.
The cause is not definitely known. All that can be said with any degree of certainty is that it is due to a poison, a product of nitrogenous disintegration, circulating in the mother's blood and due to defective functioning of the liver and kidneys.
The chief premonitory symptoms are persistent headache; high blood pressure; disturbances of vision, dimness, flashes of light before the eyes or even temporary blindness; indigestion, if persistent; diminution in the quantity of urine passed. Should the above warnings be neglected the fully developed condition gives rise to an eclamptic fit.
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Four stages of the fit can be recognized. In the first stage the pupils dilate and twitching of the facial muscles occurs. Very shortly the second stage comes on; in this the whole body is involved in a fixed spasm, the jaws being tightly clenched (the tongue may be bitten), the back is arched, and the patient becomes blue, owing to the muscles of respiration being involved in the continuous spasm. This stage lasts from one-half to one minute, at the end of which time the spasm relaxes, to be followed by the third stage, during which rapid alternate contraction and relaxation of the muscles occur. This continues for two or three minutes, to be followed by the fourth, or stage of coma, a condition of complete unconsciousness which may last for a few hours or several days.
There may be only one fit, or in some cases a long continued series of many fits. If more than twenty occur, recovery is unlikely. There may be an interval of several hours between them, or they may follow one another in rapid succession, entailing speedy exhaustion. The fit in itself is extremely dangerous to life, especially during the second stage, of continuous spasm, as the jaws, being tightly clenehcd, prevent the escape of saliva from the mouth, which may pass down the windpipe into the lungs and actually drown the patient in her own saliva. The prevention of eclampsia lies in proper and regular supervision of the woman during pregnancy and especially in the avoidance of constipation.
Treatment Treatment of eclampsia re-olves itself into the treatment of the fit itself and of the underlying condition causing the fit. Although the efficient treatment of the underlying condition calls for considerable medical skill and sound judgement, the management of the individual during the actual time of the fit is of extreme importance.