ECLAMPSIA CD
Dr. Mario L�pez-Llera M.
Let us go to the basics.
What is Eclampsia ?
How important it is?
What causes it ?
How do I recognize it?
How it affects the mother ?
And the child ?
What can I do about it ?
Is there a good treatment ?
Why have I not heard much about it
See some answers below
You could ask your own questions and we would try to give you some answers
SOME BASIC INFORMATION
Eclampsia is the worst and most advanced expression of a pregnancy complication that beggins with high blood pressure, albumin leakage through the kidneys, sometimes sudden generalized swelling and, if unchecked by propper medical intervention, may end up in convulsions, loss of consciousness and death.
In developing countries it is the main cause of maternal mortality, killing between eight and twenty mothers per each one hundred cases of eclampsia, and also causing the death of twenty to forty infants of those mothers having eclampsia. In advanced industrialized countries, things are not as bad, nevertheless eclampsia still kills about three to five per cent of the mothers having it and between ten and fifteen per cent of their infants. In addition to these losses, eclampsia also is responsible for a large proportion of all premature births and of fetuses born with restricted growth, thus seriously jeopardizing the neonatal and postnatal health of many more infants throughout the World.
The frequency or incidence of Eclampsia varies greatly from place to place and from time to time. There are no precise data because this disease as many others is grossly under-reported everywhere. It is estimated that in developing populations one case of eclampsia occurs in every one hundred to three hundred deliveries, while in highly developed populations it occurs one case in one thousand to three thousands deliveries. The incidence of lesser degrees or earlier expressions of eclampsia, that is, before convulsions, loss of consciousness or other alarming signs appear, is much higher (around eight per cent) but also their maternal and perinatal mortality is much lower, to the point that mild or moderate degrees of pre-eclampsia should carry zero maternal and perinatal mortality. And this is the crucial question, how such a disease can progress from almost zero mortality to figures as high as ten or twenty per cent?
The cause of eclampsia and of its earlier and lesser manifestations is largely unknown. Whatever the original alteration might be, it seems to be located somewhere in the feto-maternal interface ( an intimate area of the placenta). This initial dysfunction may beggin affecting the pregnancy as early as the fourth or fifth month. Although the real cause(s) of this problem have been unclear up to the present time, the various reasons why it progresses from a condition with almost zero morbidity to a very high mortality have been perfectly known throughout the XX Century. Eclampsia has been considered one of the many diseases of poverty and death from eclampsia must be considered the consequence of a chain of ommisions, delays, mistakes and sheer neglect.
Eclampsia and more so death from it have become sort of dirty words in a World with almost myracolous technological feats. Since the national figures for maternal mortality, perinatal mortality, premature births, restricted fetal growth, infant mortality, etc., are used together with many more indicators to grade the quality of life, the benefits of a given economical system, and of course the seductive promisses of politicians and administrators, all official statistics are suspects of cosmetic handling. Thus, nobody really knows the state of the matter and for further complacency, it is better no to talk about it. That is why so many persons know so little about it.
However, the fact that you are able to see this screen, read the texts and be one of the many persons with computer capacity, if female and within reproductive age, these very facts will put you in an educational level and quality of life above the dangers of eclampsia. Nevertheless, once in a very great while, highly educated people get eclampsia, because this disease has some unpredictable surprises and may run from mild to severe or very severe forms in less than a week. However, this is the exception and not the rule. How often could this problem follow this accelerated course? Hard to tell, but definitelly it must happen once in every ten cases of eclampsia at the most, and if in your community eclampsia is occurring once in every two thousand deliveries, the accelerated type should occur then once in twenty thousand deliveries. Probably you could sleep worryless, provided your obstetrician is on the alert.
Death is unavoidable. It is necessary, it may even become desirable when it comes in due time and dignified circumstances. Life and death being opposites are complementary and we cannot conceive of one without the other. But, premature death, untimely death and worst of all, death resulting from the natural need or beautiful wish to form a family, becomes a tragedy, a public offence, a social crime and as such it is unacceptable. Yes. The World is becoming overcrowded and soon there will be not enough resources for all, but letting thousands and thousands of mothers and infants die from eclampsia and other problems is not only a perverse thought but a mistaken solution to overpopulation. It has been proven repeatedly that as maternal and infant mortality rise so do birth rate and population growth, and of course poverty.
We have about fifty years of birth control, family planning and responsible parenthood, but their effects in four fifths of the World have passed unnoticed. The slogan, small families live better, is totally wrong, it is upside-down. It should say, let us improve your living conditions, your quality of life, your education and then you will have smaller families. Eclampsia and many other health problems causing high maternal and infant mortality rates are not the solution to overpopulation but one of its various causes. Not to see these facts is equivalent to the blind leading the blind in a World calling for clarity and foresight.
For more information on this population crisis go to our slides section
You could try reading also some EDITORIALS of our monthly newsletter but they are in Spanish.
You can find most complete information, services and assistance at www.apec.org.uk