Diagnosis and Management of Eclampsia: A Medical Perspective

Pregnancy in itself is a very difficult journey, and if someone has eclampsia, the journey gets even more difficult, which can lead to life-threatening situations. On top of that severe headache, blurry vision, and depression, these issues worsen the situation for the eclampsia patient.

I’m Dr. Madhu Goel, a senior consultant obstetrician and gynaecologist at Fortis La Femme, I have the extensive experience in managing high-risk pregnancies. My journey through countless surgeries has deepened my commitment to the latest management protocols in multiple maternal disorders and, in your case, eclampsia.

Understanding eclampsia isn’t just for medical professionals. We as doctors can only medically guide and help you at our chamber or hospital. As a mother and family member of a pregnant woman, it’s up to you to understand the importance of timely diagnosis and management of Eclampsia for better health of the mother and the foetus.

So, let’s get into the article to understand the diagnosis and management of eclampsia from a medical perspective.

Also Read:

• Understanding Eclampsia: Symptoms, Causes, and Risk Factors
• Diagnosis and Management of Preeclampsia: A Complete Guide

What is Eclampsia  

Eclampsia happens when there are severe complications of pre-eclampsia. It is a condition mainly diagnosed by high blood pressure, excess protein limit in urine, and, in severe cases, signs of organ damage during pregnancy. It typically occurs after the 20th week of pregnancy or during the postpartum period; the main reason it happens is when pre-eclampsia progresses to seizures, in most cases without any prior warning.

The exact cause of eclampsia remains unclear, but it is linked to several contributing factors such as reduced placental blood flow, genetic influences, hormonal imbalances, and inflammatory responses. These disruptions can also impair placental development, affecting both maternal and foetal health.

Plus, it involved symptoms such as severe headaches, blurred vision, pneumonia, kidney failure, seizures, upper abdominal pain, sudden swelling, and shortness of breath.

Diagnostic Tools

Multiple diagnostic tools are used to diagnose Eclampsia and its condition and severity. The diagnostic tools include

Blood Pressure Monitoring

High blood pressure (hypertension) is one of the hallmark signs of eclampsia. By using a sphygmomanometer and stethoscope, doctors can measure the blood pressure and check if there are any inconsistencies. Also, currently digital BP monitors are commonly used in hospitals as they come in handy for continuous monitoring.

Preeclampsia is identified when blood pressure rises to 140/90 mm Hg or higher after the 20th week of pregnancy. You should know that regular monitoring helps in the early detection of hypertension, which can lead to pre-eclampsia.

Urine Tests

The dipstick test is commonly used to detect the presence and level of protein in the urine. Besides that, 24-hour urine collection or urine protein to creatinine ratio is also used for more accurate assessment and results.

Protein in urine is one of the key indicators of pre-eclampsia and eclampsia; it’s a sign of kidney damage. Proteinuria is confirmed when the protein/creatinine ratio is 0.3 or higher, or when protein levels exceed 300 mg in a 24-hour urine sample.

Laboratory Evaluations

In labs, comprehensive tests are conducted to check if your organs are functioning properly or if there is any end-organ damage and guide management decisions.

At the lab, tests like Complete Blood Count (CBC) and Platelet Count are used to assess for thrombocytopenia. Then, liver enzymes are checked to see if there are elevated liver enzymes; serum creatinine and uric acid are checked to see kidney function, and then renal function tests and coagulation profiles are done.

Imaging and Foetal Assessment

To assess the baby’s well-being and detect any complications related to eclampsia Ultrasound is the main method used; it is done for checking fetal growth and blood flow in the umbilical artery. Then, a non-stress test (NST) for measuring fetal heart rate in response to movements. Finally, the biophysical profile (BPP) is a combined method of both ultrasound and NST to assess fetal health, including breathing, movement, muscle tone, and amniotic fluid levels.

Medical Management of Eclampsia

The management of eclampsia is a medical emergency, and it requires immediate medical attention to prevent any severe complications for both the mother and the foetus. So, here are methods to medically manage eclampsia.

Initial Assessment and Stabilization

The initial priority is to stabilize the patient’s airway, breathing, and circulation (ABCs). Positioning her on her side helps prevent choking during a seizure and enhances blood flow to the baby. Then, oxygen is given through a mask to maintain proper oxygen levels, and an IV line is set up to give medications and fluids.

After that, proper monitoring of vital signs is done, like pressure, heart rate, and breathing.

Seizure Control

For preventing seizures, magnesium sulfate is the primary medication.

IV MgSO4 4 gm and 10 gm IM as a loading dose based on Pritchard’s regimen should be administered, followed by 5 gm every four hours until 24 hours after delivery – National Library of Medicine

After the doses of MgSO4, clinicians should always monitor for side effects, as it can lead to signs of toxicity, including loss of patellar reflex, respiratory depression, and cardiac arrest.

Blood Pressure Control

Blood pressure in eclampsia often rises to dangerously high levels. This increases the risk of complications like stroke, placental abruption, and maternal organ damage.  Managing high blood pressure is important to prevent complications like stroke. So, for that, antihypertensive medications like labetalol, hydralazine, and nifedipine are used to manage severe hypertension. These drugs help reduce blood pressure to a safe range without affecting the maternal or fetal well-being.

Eclampsia After Birth and Postpartum Care

While eclampsia most commonly occurs during pregnancy. Maternal health complications can also develop in the postpartum period. It most often occurs within 48 hours after childbirth, though in some cases it can develop as late as six weeks postpartum.

This is known as postpartum eclampsia and requires the same level of urgency in management. Symptoms like seizures, severe headache, and high blood pressure after birth should never be ignored.

Postpartum care for these patients involves continued seizure control using magnesium sulfate and monitoring blood pressure in eclampsia. New mothers should be closely observed for signs of recurring symptoms and undergo follow-up evaluations to manage risks. A proactive approach in postpartum care ensures long-term health and reduces maternal complications after delivery.

Conclusion

Eclampsia is a critical, potentially life-threatening condition that requires prompt recognition and intervention. Regular monitoring of blood pressure, urine protein levels, and lab parameters plays a key role in early detection. Timely treatment—including magnesium sulfate for seizure prevention and medication to manage high blood pressure—is essential to safeguard the health of both mother and baby.

Addressing blood pressure in eclampsia and monitoring for pregnancy-related seizures helps ensure better outcomes in high-risk pregnancies. Post-delivery, postpartum care remains vital to prevent recurrence. Understanding these aspects empowers patients and caregivers to act quickly and seek expert medical help for a safer, healthier pregnancy journey.

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Dr. Madhu Goel
Senior Consultant Obstetrician and Gynaecologist
Director, Fortis La Femme

I am passionate about women’s health. With expertise in managing high-risk pregnancies, infertility, and various gynaecological issues, I strive to provide compassionate care. I am committed to ensuring the well-being of my patients. Follow me for insights and updates on women’s health.

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