From the Guidelines
Eclampsia, a severe complication of preeclampsia, is a leading cause of maternal death worldwide.
Causes of Death in Eclampsia
The main causes of death in eclampsia include:
- Hypertensive disorders, which are responsible for 14% of maternal deaths globally, making them the second most common cause of direct maternal deaths 1
- Preeclampsia, which is characterized by new-onset hypertension with proteinuria during pregnancy, and is a major cause of maternal and neonatal mortality and morbidity 1
- Chronic hypertension, which increases the risk of growth-restricted infants and superimposed preeclampsia 1
- Systemic racism and discrimination, which can lead to inequitable treatment and poor health outcomes for black women 1
Key Factors Contributing to Mortality
Key factors contributing to mortality in eclampsia include:
- Failure to identify and act on known risk factors at booking and to recognize and respond to signs and symptoms from 20 weeks’ gestation 1
- Lack of access to quality care and inequitable treatment 1
- Increased risk of preterm birth, intrauterine growth restriction, and low birth weight 1 It is essential to address these factors to improve outcomes related to preeclampsia and eclampsia, particularly in low- and middle-income countries where the risk of preeclampsia-related maternal death is higher 1.
From the Research
Causes of Death in Eclampsia
The causes of death in eclampsia, a severe complication of preeclampsia, are multifaceted and can be attributed to various factors. Some of the key causes include:
- Lack of prenatal care and access to hospital care, particularly in developing countries 2, 3
- Inappropriate diagnosis and management of patients with preeclampsia-eclampsia 2, 4
- Limited access to resources, including magnesium sulfate, which is a crucial treatment for preventing and controlling eclamptic seizures 3, 5
- High blood pressure and its complications, such as stroke, cardiac arrest, and renal failure 3, 6
- Placental abruption, disseminated intravascular coagulation, pulmonary edema, aspiration pneumonia, and cardiopulmonary arrest 6
Maternal Mortality and Morbidity
Eclampsia is a leading cause of maternal mortality, particularly in developing countries, where the incidence of eclampsia is higher due to limited access to healthcare resources and prenatal care 2, 3, 4, 6. The mortality rate of young mothers with eclampsia is significant, ranging from 5-20% 5. Additionally, eclampsia is associated with increased risk of maternal morbidity, including long-term cardiovascular risk and cognitive difficulties related to memory and concentration years after the index pregnancy 6.
Prevention and Management
Prevention and management of eclampsia are critical to reducing maternal mortality and morbidity. Clear protocols for early detection and management of hypertension in pregnancy, as well as timely delivery and access to healthcare resources, are essential for better maternal and neonatal outcomes 2, 3, 6. Magnesium sulfate is a crucial treatment for preventing and controlling eclamptic seizures, and its use should be scaled up in low- and middle-income countries to achieve the Millennium Development Goals 3.