Eclampsia usually occurs in first pregnancy unless change of partner.
Systolic BP > 160
Diastolic BP > 110 or (>15 mmHg above booking)
Proteinuria > "+" / 500 mg/24
Neurological - headache, visual disturbance and convulsions
Epigastric pain and tenderness
HELLP (Haemolysis, Elevated Liver enzymes and Low Platelets)
Pre-eclampsia as a syndrome specific to pregnancy
Disorder of endothelial function (placental / maternal vascular trees)
20% of maternal mortality
Commonest recognised cause of fetal growth retardation
Fitting due to pregnancy induced hypertension
May be atypical
May occur post partum
Progress halted only by delivery of the fetus (and placenta).
Upper abdominal pain in pregnancy may indicate pre-eclampsia
All women who present with upper abdominal pain and tenderness in pregnancy (usually after 20 weeks' gestation):
Measure B.P. If > 140/90 mmHg seek advice from the obstetric unit in which the woman is booked
Test for proteinuria. If proteinuria (i.e., more than a trace) is present in an MSU and especially if hypertension is detected refer immediately for admission to the maternity unit. (Don't take "No" for an answer
Once admitted, blood should be analysed for, among other things, thrombocytopaenia and hepatic dysfunction.
If you remain concerned about the epigastric pain and tenderness in the absence of hypertension or proteinuria review the following day.
Treatment of Eclampsia
High flow oxygen
Place in left lateral; position, suction available