Introduction
The term eclampsia defines a serious and acute complication of gestosis: exclusive of pregnancy, eclampsia is a syndrome characterized by hypertension, edema and proteinuria associated with convulsions and coma.
Therapy and prevention
Early identification of "suspicious" signs and symptoms is essential for early eclampsia therapy, minimizing the risk of catastrophic sequelae.
Pregnant women, who are familiar with pre-eclampsia, should follow a specific drug therapy to prevent gestosis and eclampsia.
The eclampsia is a medical emergency in all respects: to safeguard the survival of the mother and the fetus, immediate medical intervention is essential.
- One of the key goals of eclampsia therapy is to REDUCE ARTERIAL PRESSURE . The pressure reduction must be gradual : during the first hour after the onset of symptoms, the pressure must be reduced by 20-25%.
The rapid decrease in average pressure (by 50%) during the first hour after the onset of symptoms can trigger catastrophic consequences, such as cerebral ischemia, cardiac ischemia and reduction of placental perfusion associated with fetal impairment and suffering.
The most commonly used antihypertensive drugs in therapy are clonidine, labetalol and diazoxide salts (or simply Diazoxide ): in similar situations, continuous monitoring of the fetal heart rate is indispensable.
Diuretics can only be taken in cases of pulmonary edema in the context of eclampsia.
- Another goal is to MINIMIZE the risk of CONVULSIONS : women with gestosis or who are otherwise familiar with eclampsia should follow an anticonvulsant therapy with preventive purposes. Magnesium sulfate (to be taken parenterally) appears to be the drug of choice: for the prevention of complications in the context of eclampsia, magnesium sulfate seems to offer many more benefits than administering diazepam or phenytoin. Administration of diazepam (at a dose of 10 mg / ev) or thiopental (50 mg / ev) is indicated exclusively in the case of repeated convulsions in the context of eclampsia, where magnesium sulfate is not effective.
- It seems that the ADMINISTRATION OF ASPIRIN at low doses (or other antiplatelet agents) gives surprising results for the prevention of gestosis and eclampsia. Aspirin, in fact, by blocking platelet aggregation and vasospasm, prevents eclampsia, reduces the risk of pre-term birth, minimizes the risk of fetal mortality and does not increase the likelihood of placental abruption. However, it is important to underline that there are not enough data available to confirm the validity of these drugs in the treatment of pre-eclampsia.
- OXYGEN ADMINISTRATION to the mother with eclampsia may be necessary to facilitate breathing and correct hypoxia.
- STEROID PHARMACEUTICALS may also be useful to improve the function of liver and platelets in the mother; furthermore, it appears that taking corticosteroids in women with preeclampsia is useful for prolonging pregnancy and promoting fetal lung development, reducing the risk of eclampsia.
- From what is reported in the scientific journal BMJ (British Medical Journal), it seems that A DIFFERENT FOOD OF ANTIOXIDANTS and of foods containing L-arginine reduces the risk of pre-eclampsia and eclampsia in high-risk women. In particular, the risk of gestosis is minimized when this diet is undertaken before 24 weeks of gestation.
Considerations
As we have seen, an eclampsia status is not only dangerous for the mother: even the unborn child can suffer heavily. Hence the need to anticipate the birth as soon as possible, even if the fetus is immature. However, this type of intervention is not always possible, since the child may not even have completed his development.
Any advance in labor can only occur when the condition of the woman with eclampsia has stabilized.
