What is convulsion in pregnancy? – Convulsion is a rare but serious complication of pregnancy. The most common form of convulsion in pregnancy is eclampsia. This is usually preceded by preeclampsia, characterized by high blood pressure and the presence of protein in urine after 20 weeks of pregnancy. Convulsion is the most severe complication of preeclampsia. However, eclampsia may occur without preeclampsia.

What are the risk factors for convulsion in pregnancy?

The following are common risk factors for convulsion in pregnancy:

1. Preeclampsia – hypertension and protein in urine after 20 weeks of pregnancy
2. First ever pregnancy or first pregnancy for a new partner
3. Current pregnancy after ten years of previous pregnancy
4. Teenage pregnancy (especially below 18 years)
5. Pregnancy after 35 years of age
6. Twin pregnancy or higher order multiple pregnancy
7. Obesity (BMI > 30kg/m2)
8. Medical diseases in pregnancy such as diabetes, hypertension, kidney diseases
9. Preeclampsia in previous pregnancy
10. Family history of preeclampsia or eclampsia

What symptoms precede convulsion in pregnancy?

Usually, before convulsions set in, women may feel one or a combination of the following:

1. Severe headache
2. Blurring of vision
3. Seeing flashes of light / double vision or loss of vision
4. Nausea and vomiting
5. Reduced urine output
6. Right sided upper abdominal pain
7. Generalized body swelling

These are symptoms of severe preeclampsia which often precede convulsion. Convulsion may be prevented if these symptoms are recognized early and treatment initiated timely.

What symptoms come with convulsion in pregnancy?

Patients with convulsion in pregnancy often present with:

1. Frequent seizures
2. Loss of consciousness
3. If conscious, may be confused
4. Restlessness and agitation
5. Breathing difficulty / heavy breathing

How is eclampsia treated?

The definitive treatment for convulsion in pregnancy is delivery of the baby and placenta. This may be through induction of labour or caesarean section. However, prior to delivery, certain measures are taken to make the woman stable enough to undergo the delivery process. These include:

1. Stopping the seizures by administration of anticonvulsant medication
2. Control of blood pressure by antihypertensive medication
3. Giving drip (in regulated amount) to improve blood circulation

What are the complications of convulsion in pregnancy?

The complications of convulsion in pregnancy may affect both the mother and child. They include:

1. Mother: Tongue laceration following tongue biting; fracture from injuries sustained during convulsion; stroke from high blood pressure; excessive bleeding from blood clotting defect; premature separation of placenta; preterm labour or death
2. Child: Preterm delivery, with associated complications such as: difficulty with breathing, susceptibility to cold because of thin skin, difficulty with feeding etc, stillbirth

How can convulsion in pregnancy be prevented?

Convulsion in pregnancy can be prevented by:

1. Creating awareness about the condition: Women should be aware of the dangers of convulsion in pregnancy and how to prevent it.
2. Regular antenatal care attendance: Every pregnant woman should be encouraged to register for antenatal care and attend regularly. This helps in early detection of hypertension and protein in urine that usually precede the convulsion which can then be treated or delivery effected before it degenerates into convulsion.
3. Teenage pregnancy should be prevented as much as possible
4. Women should be encouraged to complete their reproductive career before age 35 years
5. Good nutrition / balanced diet