Eclampsia: what it is, symptoms, treatment and warning signs

Eclampsia is one of the serious complications of pre-eclampsia. The NHS describes pre-eclampsia as a pregnancy-related condition that causes high blood pressure, and lists seizures (eclampsia) among the serious, possibly life-threatening complications, alongside HELLP syndrome (a rare liver and blood disorder), stroke and stillbirth. The RCOG says that if you have a seizure because of pre-eclampsia, it is called an eclamptic fit or eclampsia.

Pre-eclampsia usually causes high blood pressure and protein in the urine, and can affect the liver, kidneys, brain and blood clotting. The RCOG says around 1 in 200 women develop severe pre-eclampsia, which can be life-threatening for both mother and baby, and that eclampsia is rare, affecting 1 in 3,000 pregnancies in the UK.

Eclampsia itself is a seizure. What matters most is recognising the warning signs of pre-eclampsia before a fit happens. The NHS says early signs of pre-eclampsia are high blood pressure and protein in your pee, which you are unlikely to notice, so you are offered regular blood pressure and urine checks at antenatal appointments.

The NHS and RCOG both list the symptoms below, say any of them can be serious and say they need to be checked immediately. The RCOG says you often have no symptoms at all, and that they usually happen towards the end of pregnancy but can also happen for the first time after the birth.

• A severe headache that does not go away with simple painkillers.

• Vision problems, such as blurred vision or seeing flashing lights.

• Pain just below the ribs.

• Heartburn that does not go away with heartburn medicine.

• Sudden or rapidly increasing swelling of the face, hands or feet.

• Feeling very unwell, and being sick (vomiting).

The NHS says to get urgent medical help if you are pregnant, or have given birth in the last few weeks, and have symptoms of pre-eclampsia. If you are pregnant, call your maternity unit if you have the number. If you have recently given birth or cannot call your maternity unit, call 111.

For a seizure, the NHS general advice on seizures says to call 999 if you think someone is having a seizure and it is the first time it has happened, it lasts longer than 5 minutes if you do not know how long their seizures usually last, they do not recover as usual afterwards, or they have another seizure without recovering in between. A seizure in pregnancy or soon after birth is an emergency in the same way.

The RCOG says that if you develop severe pre-eclampsia you will be admitted to hospital and cared for by a specialist team, which may be in a high dependency or intensive care unit. Treatment may include medication, by tablets or a drip, to lower and control blood pressure. You may also be given magnesium sulfate to reduce the chance of an eclamptic fit. The RCOG says this medication can also be used to treat eclampsia if you have already had a fit.

The RCOG says the only way to cure pre-eclampsia is for your baby to be born, and the NHS says it is often safer for the baby to be born early, in some cases before 37 weeks. Labour may be induced or you may be offered a caesarean section, depending on your situation. The NHS says you are monitored in hospital after the birth.

The NHS says it is not known what causes pre-eclampsia. Action on Pre-eclampsia says it is caused by a defect in the placenta. The risk factors below are listed by the NHS and RCOG.

• Having high blood pressure before pregnancy or in a previous pregnancy.

• Kidney disease, diabetes, or an autoimmune condition such as lupus or antiphospholipid syndrome.

• Having had pre-eclampsia in a previous pregnancy.

• A first pregnancy, being aged 40 or over, or 10 years or more since the last pregnancy.

• A body mass index (BMI) of 35 or more before pregnancy.

• Carrying more than one baby, or having a mother, sister or other relative who had pre-eclampsia.

• Being from a Black or South Asian ethnic background (NHS).

The NHS says it is important to attend all your antenatal appointments, where your midwife can work out whether you are at risk and check your blood pressure and urine. If a midwife or doctor thinks you are at higher risk they may prescribe aspirin every day from week 12 of pregnancy until the baby is born, or calcium supplements if you do not get enough from your diet. The RCOG gives the aspirin dose as 75 to 150 mg once a day from 12 weeks until 36 weeks.

The NHS says not to start taking aspirin or calcium unless advised by a midwife or GP. Maintaining a healthy weight through a balanced diet and exercise can also help lower your risk.

The RCOG says pre-eclampsia goes away after birth, but complications may still happen within the first few days, so you continue to be monitored closely. You will need blood pressure checks after leaving hospital, may need medicine for several weeks, and should have a follow-up appointment 6 to 8 weeks after the birth. The NHS says sometimes pre-eclampsia develops in the days or weeks after your baby is born.

The RCOG says pre-eclampsia can happen again, and the chance depends on how early the baby needed to be born: about 1 in 3 if birth was between 28 and 34 weeks, 1 in 4 if before 34 to 37 weeks and 1 in 6 if after 37 weeks. It also says you are advised to take aspirin from 12 weeks in any future pregnancy, to contact your healthcare team early to plan care, and that having pre-eclampsia increases the risk of high blood pressure, stroke and heart disease later in life.

On the NHS, monitoring for pre-eclampsia is part of routine antenatal care with your midwife, and a suspected case is referred to a maternity day unit or hospital for blood tests and scans. Severe pre-eclampsia and eclampsia are always treated in hospital.

Some people choose private maternity care. An emergency is always handled by the nearest hospital. Whichever route you choose, know the number of your maternity unit and keep your blood pressure results in your maternity notes.