Complications of Eclampsia

-K.Mohan Ram

MATERNAL• Placental abruption —10 percent

• Neurological deficits —7 percent

• Aspiration pneumonia —7 percent

• Pulmonary edema —5 percent

• Cardiovascular problems —4 percent

• Acute renal failure —4 percent

• Death —1 percent

FETAL

• Prematurity

• IUGR

• Hematological changes

• Broncho Pulmonary disease

• Neurodevelopmental Outcome

• Fetal Origins of Adult Disease States

Placental abruption

Coagulopathy

increased factor VIII consumption

increased levels of fibrinopeptides A and B

increased levels of fibrin degradation

products

decreased levels of regulatory proteins

(antithrombin III, protein C,

protein S)

Coagulation aberrations found in eclampsia

THROMBOCYTOPENIA

• Routine laboratory assessment (PT, APTT, p.fibrinogen level) – unnecessary.

ECLAMPSIANO PLACENTAL

ABRUPTION

ECLAMPSIAPLACENTAL ABRUPTION

Neurological deficits

perivascularedema

cerebral infarctions

subjectively impaired cognitive

functioning

Pulmonary edema

Pulmonary edema

alveolar endothelial-

epithelial leak

ventricular failure

aspiration pneumonia

Cardiovascular problems

Eclampsia

Metabolic syndrome

Diabetes

Obesity

Dyslipidemia

Atherosclerosis

ischemic heart

disease

stroke

chronic hypertensio

n

Acute renal failure

Renal pathology is both endothelial and epithelial

Eclampsia

HELLPsyndrome

placental abruption

hemorrhagic hypotension Acute tubular

necrosis

Renal cortical necrosis

Death

hypertensive disorders

Renal failure

Hemorrhagic disorders

Cerebrovascular haemorrhage

Cardio-pulmonary failure

DIC

Sepsis

IUGRHematological

changesPrematurity

Broncho pulmonary

disease

Neuro developmental

problems

Fetal origin of adult diseases

IUGR

Eclampsia

Uteroplacental insufficiency

IUGR

Hematological changes

PREMATURITY

Increased oxidative stress

Broncho pulmonary disease

Vascular hypothesis of BPD

Neurodevelopmental Outcome

Decreased risk of cerebral palsy

Lower incidence of IVH

Lower MDI scores

Fetal Origins of Adult Disease States

Hypertension Obesity

DiabetesCardiovascular

morbidity

References

Williams-Obstetrics - 23rd-Edition

The causes of maternal deaths in eclampsia in Lagos, Nigeria. Odum CU, Akinkugbe A. West Afr J Med. 1991 Jan-Mar;10(1):371-6.

PMID: 2069883 [PubMed - indexed for MEDLINE]

Journal of PregnancyVolume 2011 (2011), Article ID 214365, 7 pages

doi:10.1155/2011/214365

Preeclampsia: Effect on the Fetus and Newbornde Souza Rugolo, et al. Neoreviews 2011; 12:e198-e206