Study note
Obstetrics & GynecologyHypertensive Disorders in Pregnancy

Eclampsia: incidence and proposed mechanisms of convulsions

THE CONTEXT
Eclampsia is a severe form of pre-eclampsia and may also occur when pre-eclampsia is superimposed on essential hypertension or chronic nephritis.

Incidence and associations

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Incidence varies between countries and between regions within a country. Eclampsia contributes significantly to maternal deaths.
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The reported hospital incidence in India ranges from 1 in 500 to 1 in 30.
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Primigravidae account for 75% of cases. Eclampsia is five times more common in twin pregnancies than in singleton pregnancies.
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More than 50% of cases occur between the 36th week and term.

Pathophysiology and cerebral irritation

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Histopathological and biochemical changes resemble those of pre-eclampsia but are more intense.
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The cause of cerebral irritation leading to convulsions is unclear.
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Cerebral vessel spasm may increase cerebral vascular resistance, reduce cerebral oxygen consumption and lead to anoxia.
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Cerebral edema may contribute to irritation. Cerebral dysrhythmia increases following anoxia or edema.
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