Eclampsia is a rare but potentially life threatening condition of pregnancy and postpartum. The complications include serious events like seizures, blood clots, and stroke. Emergency treatment is essential.

Eclampsia occurs when a person with preeclampsia develops seizures. This can happen during pregnancy or shortly after delivery and is a medical emergency. In addition to seizures, a person with eclampsia may have other very serious medical conditions.

These conditions are considered complications of eclampsia. Effective treatment options exist, and recovery is possible. Read on for more information about the complications of eclampsia and the treatment options for each.

Preeclampsia is a disorder of pregnancy associated with newly occurring (new onset) high blood pressure and proteinuria, a condition when you have too much protein in your urine. (Some people have preeclampsia without proteinuria.)

Preeclampsia may lead to seizures. If a pregnant person with preeclampsia has seizures, they have developed eclampsia — a life threatening condition. While it’s possible to have eclampsia without preeclampsia, it’s much more common to have preeclampsia first.

Caused by high blood pressure (hypertension), seizures are both the defining sign of and a complication of eclampsia. When an individual has eclampsia, these seizures may cause other conditions as well. Some of which may be life threatening.

The most common type of seizures that occur in eclampsia are grand mal seizures, also called tonic-clonic seizures. These seizures involve the entire body.

Racial disparities in preeclampsia and eclampsia

Preeclampsia affects 3% to 8% of all pregnancies worldwide.

According to the Centers for Disease Control and Prevention (CDC), in the most recent report of maternal mortality rates (from 2022), the death rates for Black, non-Hispanic people during pregnancy have declined. However, Black women still have a significantly higher death rate than other racial groups.

For this time period, the CDC reports the maternal mortality rate for Black, non-Hispanic women was 49.5 deaths per 100,000 live births. This rate was significantly higher than rates for white (19.0), Hispanic (16.9), and Asian (13.2) women.

More specifically, a 2022 study in the United Kingdom reported Black women had a 2 times greater risk of developing total preeclampsia and a 2.5 times greater risk of developing preterm preeclampsia than white women.

Racial biases affect healthcare and health outcomes in several ways. According to the CDC, these factors include psychosocial stress from experiencing racism, differences in access to healthcare, and differences in the quality of healthcare delivered.

These factors contribute to chronic hypertension and are likely to increase the incidence of preeclampsia and eclampsia affecting Black individuals during pregnancy.

Seizures of eclampsia can lead to additional complications such as high blood pressure (hypertension) and protein in the urine (proteinuria).

Postpartum eclampsia occurs after a person delivers the baby. Treatment must begin as soon as possible to control the seizures, stabilize the individual, and prevent injury to organs like the brain, eyes, liver, and kidneys.

Pulmonary edema involves a buildup of fluid in the lungs. The excess fluid prevents the lungs from functioning fully, makes it difficult to breathe, and can rapidly become life threatening. Preeclampsia and eclampsia can both cause pulmonary edema.

A stroke is a medical emergency that happens when the blood supply to areas in the brain slows or stops. This limits oxygen to these areas and causes injury.

Stroke during pregnancy (perinatal stroke) is very rare. People with eclampsia may be more likely to have a stroke because of the seizure activity and high blood pressure associated with the condition.

An embolism is a blood clot. When a blood clot or a piece of a blood clot breaks away from where it forms and travels to another location in your body, it can slow or stop blood flow to that vessel and surrounding tissues. This is called thromboembolism.

If an embolism travels to the lungs, it’s called a pulmonary embolism. If it travels to a vein, it’s called a venous thrombosis or deep vein thrombosis (DVT). If it travels to the brain, it may cause a stroke.

Eclampsia and preeclampsia may cause thromboembolism. If this happens, it’s a medical emergency requiring immediate care. Treatment usually involves medication to thin your blood or surgery to help remove the thromboembolism.

The main treatment for eclampsia is to deliver the baby. If eclampsia develops before week 37 of pregnancy, doctors consider the delivery a premature delivery and the baby premature. The earlier in pregnancy delivery occurs, the greater the risks of prematurity to the baby.

Premature delivery can cause complications for a baby, such as:

  • breathing difficulties
  • feeding difficulties
  • cerebral palsy
  • developmental delay
  • vision changes
  • hearing changes

If a medical professional doesn’t start treatment immediately, both the birthing parent and baby may die. Eclampsia can become dangerous very fast, and emergency care is essential. The pregnant person will need to deliver the baby even if it means the baby will be very premature.

Eclampsia is the most serious complication of pregnancy, accounting for 5% to 20% of deaths during pregnancy. Preeclampsia and eclampsia are among the most common causes of death during pregnancy and delivery, especially in underserved communities. These conditions are the leading causes of maternal death for non-Hispanic Black women, occurring 5 times more than in non-Hispanic white women.

Non-Hispanic Black and non-Hispanic American Indian/Alaska Native people and those with limited access to prenatal care are disproportionally affected by this rare but life threatening condition.

Treatment for the complications of eclampsia is critical and a doctor must start it as soon as possible. Treatment options include:

Delivering the baby

An emergency cesarean delivery, commonly referred to as a C-section, is generally necessary, even if that means a premature delivery. This can often stop symptoms, protect both the birthing parent and baby, and prevent more serious complications.

Medications

Medications help stop seizures, lower blood pressure, reduce fever, and prevent organ injury. Medications that medical professionals may use to treat complications of eclampsia include:

  • Magnesium sulfate: Magnesium sulfate helps stop seizures during eclampsia.
  • Anticonvulsants: Antiseizure medications (anticonvulsants) help stop seizure activity.
  • Antihypertensives: Antihypertensive medications help lower blood pressure.
  • Corticosteroids:Steroids help a baby’s lungs develop faster. During eclampsia treatment, steroids may be given prior to labor, during labor, or after delivery.

Surgery

The main surgical treatment for eclampsia and its complications is cesarean delivery. Other surgical treatments may include vascular surgery to remove blood clots and embolism.

Eclampsia is a serious medical condition that occurs during pregnancy or shortly after delivery. It’s a medical emergency and may lead to several other serious conditions in a pregnant person. These conditions include things like blood clots, stroke, and others.

Eclampsia and the complications that develop because of it are medical emergencies that can quickly become life threatening to both the birthing parent and baby. However, treatment can be very effective. Delivering the baby is the main treatment option. Other treatment options include medications and surgery.

Though healthcare professionals can effectively treat many complications of eclampsia, some may affect an individual’s health long term.