Left untreated, eclamptic seizures can result in coma, brain damage, and possibly maternal or infant death.

The standard course of treatment for eclampsia is magnesium sulfate. This simple salt saves mothers lives. According to the Collaborative Eclampsia Trial (CLASP) published in The Lancet, June 95, women on magnesium sulfate had  

• 52% lower risk of recurrent seizures than those on diazepam;
• Those who did have recurrent seizures had fewer than those on diazepam;
• 26% lower risk of maternal death than those on diazepam;
• Babies of mothers on magnesium were in better condition after delivery and less likely to need special care;
• Less likely to be ventilated or develop pneumonia or to need intensive care than those on phenytoin;
• 67% lower risk of recurrent seizures than those on phenytoin;
• 50% lower risk of maternal death than those on phenytoin.

Nevertheless, magnesium sulfate, is not a benign drug and must be used by a skilled health care provider with appropriate support facilities. Overdoses can and do occur.

It is important to note that while magnesium sulfate has often been compared to Epsom salts--they are not the same. Ingesting Epsom salts, or magnesium vitamin supplements have not been shown to prevent maternal death due to eclamptic seizures.

• Previous history of preeclampsia, particularly if onset is before the third trimester
• History of chronic high blood pressure, diabetes or kidney disorder
• Family history of the disorder (i.e., a mother, sister, grandmother or aunt who had the disorder)
• Women with greater than 30% Body Mass Index (BMI). To determine your BMI, click on the following link http://nhlbisupport.com/bmi/bmicalc.htm and follow the instructions there.
• Multiple gestation
• Over 40 or under 18 years of age
• Polycystic ovarian syndrome
• Lupus or other autoimmune disorders such as rheumatoid arthritis, sarcoidosis or MS.
  
  

Prematurity

Preeclampsia is responsible for 15% of premature births in the US each year. It is the leading known cause of preterm birth. According to the March of Dimes, in 2001, 476,250 infants were born prematurely…over half from unknown causes. Preeclampsia represents 30% of the known causes of prematurely--or approximately 70,000 premature births.

A baby is considered premature prior to 36 weeks gestation (one month early) but most severe prematurity issues occur to babies born before approximately 32 weeks in developed countries, and somewhat later in developing countries. (As developing countries often lack the standard of critical care that preemies require). The impact of prematurity is not fully known, even in infants who were only slightly premature.

Intrauterine Growth Restriction (IUGR)

Reduced blood flow to the placenta restricts the supply of food to the baby and can result in a shortage of food and subsequent starvation. As a result, they may be smaller for their gestational age. Ultrasounds can help identify IUGR. The good news is many babies who suffer from IUGR can catch up on their growth within a few months.
It is important to note that many women blame themselves or poor nutrition for IUGR. Such problems are caused by a failing placenta and not the mother’s diet. A woman could be eating all of the right things but if the placenta is not capable of passing such nutrients along--the baby will suffer.

Acidosis

The baby survives by receiving nutrients and oxygen through the placenta. In preeclampsia, the placenta becomes compromised and the baby’s body begins to restrict blood flow to the limbs, kidney and stomach in an effort to preserve the vital supply to the brain and heart. If the baby reaches the point where there is no further reserve of oxygen (as the placenta detaches or dies) the baby’s body can extract energy from its fuel supplies without oxygen. This process generates a poisonous waste product--lactic acid. If too much lactic acid builds up the baby will develop “acidosis” and become unconscious and stop moving. Delivery is essential at this point. (thanks to: Pre-Eclampsia: The Facts, by Redman, Walker, 92).

Death

Infant death is one of the most devastating consequences of preeclampsia. It is impossible to say how many infants die each year, however, we estimate that at least 1200 babies die due to preeclampsia in the US alone. Many countries do not have the means to keep a premature baby alive. In these countries--the death toll is significant.

At the Preeclampsia Foundation a full 20% of our members have lost at least one baby or suffered a miscarriage. Because this disease can manifest in a very short time--a woman can have a normal prenatal appointment in the morning and lose her baby by the afternoon. We encourage our women to err on the side of caution.

Ongoing life challenges

Preeclampsia has been linked to a host of lifelong challenges for infants born prematurely, among them learning disabilities, cerebral palsy, epilepsy, blindness and deafness. With prematurity also comes the risk of extended hospitalization, small gestational size and the interruption of valuable bonding time for families. Prematurity stresses a family unit, and this stress is compounded when the mother is also ill.

Some studies suggest that babies born to a preeclamptic mother have an increased risk of high blood pressure and diabetes later in life. Very few studies have followed the health of these babies.

Education, vigilance and being proactive patients can reduce some of these deaths but ultimately-we need more research. We need to find a cure.

If you had a normal first pregnancy, your risk of having preeclampsia in the next pregnancy is very low, however if you have other risk factors (such as advanced maternal age, excess weight, family history of hypertension) you should still be watchful and alert to early warning signs. A study in Aberdeen, Scotland showed that nearly 1 in 150 women whose blood pressures had been entirely normal in their first pregnancy had preeclampsia in a second pregnancy. (ref: Preeclampsia: The Facts by Redman, Walker 1992)

There has not been significant research looking at the rate of reoccurrence in subsequent pregnancies, however the consensus among experts is that preeclampsia in a previous pregnancy is the single largest risk factor for developing preeclampsia. It is entirely wrong to say that if you had it in your first--you will not get it again. The risk of having it again is approximately 20%, however experts cite a range from 5-80% depending on when you had it in a prior pregnancy and how severely you had it.

The risk increases if since your previous pregnancy you have developed chronic hypertension, diabetes, or if you are having IVF, twins or other multiples, as well as the risk factors mentioned above.

If you do not have preeclampsia in a second pregnancy, your risk for reoccurrence in a third is low, though it can happen.