Eclampsia

Eclampsia (flash (lat.) - a kind of condition that occurs in pregnant women on the grounds of altered reactivity of the body, in connection with a deep disorders in the course of metabolic processes.
Particularly severe symptoms of toxemia (toxicosis) marked among those women who neurotic phenomena existed before this pregnancy, and when they had even those or other disorders on the part of the somatics.
In table. 17 presents a separate clinical forms (pure or mixed) and stage of development of toxemia that can be either acute (47,2%)and slow for (52,8%). We think this division is most appropriate.

Table 17. Toxemia (toxicosis) late pregnancy
Clinical forms Stage of the process
Clean form 1. Swollen due to violation of water-salt metabolism
2. Vascular, manifested in the change of vascular tone and related violations in the form of Hyper - or hypotension
3. Renal (nephropathy), accompanied by disturbances in protein metabolism (albuminuria, azotemia and so on)
4. Predatorily (preeclampsia) - functional disorders of the Central nervous system, namely the disorder of cerebral circulation, cerebral edema, increased intracranial pressure, etc.
5. Convulsive (explicit) and hidden (non-convulsive) eclampsia
Mixed forms Mixed forms occur on the background existed even before this pregnancy hypertension and hypertensive disease, or a variety of other violations by the somatics or nervous and mental diseases

Eclampsia is the final link in the chain disorders observed in the body, women with toxemia late pregnancy (oedema, hypertension, nephropathy, pre-eclampsia, eclampsia).
However, this does not mean that every case of toxemia in the stage nephropathy must necessarily end eclampsia. The last stage (eclampsia) occurs mainly in acute advanced form nephropathy (18,2%, I. I. Yakovlev).
Clinically state eclampsia is characterized by a pregnant women (mothers, postpartum women and adolescent girls) are observed loss of consciousness and seizures.
Predatoraze (preeclamptic) condition, usually characterized by elevated blood pressure (BP). The height maximum HELL of women ranges from 130 to 200 mm RT. Art., and sometimes even higher. These fluctuations maximum HELL due to the fact that among women who have symptoms of toxemia, 15% of meet woman, who had had prior to this pregnancy vascular pathology such as arterial hypotension. For them, a rise in blood pressure in the second half of pregnancy to 130-135 mm RT. Art. would be pathological. These persons (if this symptom in combination with other signs) should be considered as threatened in respect of the possibility that they eclampsia, and increased blood loss during delivery (in succession period).
Other pregnant women with typical clinical picture toxemia, maximum HELL within 100 mm RT. Art. and below should be considered as a manifestation of toxemia (L. E. Weissman).
The fairness of such claims to convince the work of several authors. So, even in 1923, F. Muller, G. F. lang, N. N. Kurshakov indicated that the etiology and pathogenesis of hypertension and hypotension one. Currently, a number of authors considers that hypertonic and hypotonic condition are only different categories of the same process, the emergence and development which is due to the condition of the Central and autonomic nervous system, the state of the Pressor and depressant mechanisms (M. P. Kozlovskaya, and others).
Characteristic symptomatic hypotension is the normalization of blood pressure after liquidation of state late toxemia, and often even after the disappearance of signs of a seizure toxemia in response to the regime and treatment.
Simultaneously with increase of blood pressure in this category pregnant women quickens and becomes more intense heart rate, swelling, decreased urine output, increases in the urine protein (from 0,1 up to 50%) and in it there are hyaline and granular cylinders, and the formed elements, which indicates the possibility of kidney damage.
However, it should be borne in mind, as was mentioned earlier that the emergence of albuminuria does not mean necessarily kidney damage. Often these patients are marked disorders of the gastrointestinal tract, nausea, vomiting, pain in pancreatic area and healthy before the stomach and liver) and visual impairment (see badly, complain flicker before my eyes).
In connection with the above changes in the subjective state of pregnant changes dramatically; it feels broken, tired, it really bothers headache, somnolence, in other cases, and Vice versa, pregnant falls into a state of strong excitation. Her face becomes puffy, with obvious signs of cyanosis.
The closer seizure headache pregnant woman becomes unbearable; HELL is rising sharply, and all the rest of the above symptoms become pronounced.
Shortly before the attack, there are fibrillar twitching of muscles of the face and upper extremities. In this connection, it is of great practical importance, the determination of the temporal (intracranial pressure, which allows to prevent the development of impending disaster in the woman's body.
The state of eclampsia is usually short-term (a few hours during the day); less often this condition is observed within 2-3 days.


Timely taken treatment is possible to prevent the occurrence of convulsions and so improve the condition of the patient that occurred in her childbirth occur often without any complications.
Described the syndrome is clearly expressed in 85%. 15% signs eclampsia appear so weak that not enough of the Supervisory doctor may even their catch. This circumstance, in our opinion, can be explained erroneous claims of a number of authors, though in some cases eclampsia can occur suddenly, without warning.
So, the offensive eclampsia is characterized by the appearance of seizures. Cramps is a terrible symptom in eclampsia!
However, along with convulsive form eclampsia, exists and non-convulsive its form, which is available sharp violation of the functions of the Central nervous system, apparently, is caused by the accumulation in the body of a pregnant woman in excessive quantities of new substances, mainly protein nature, the so-called biogenic amines with high toxic properties.
Simultaneously, there has been a significant defeat of the respiratory centre and the decline of cardiac activity.
So, eclampsia without convulsions due to the fact that in the circle of blood come in excessive quantities of toxic substances, which quickly paralyze major nerve centers. In explanation of this phenomenon can be used regularities arising from the teachings N. That is, Vvedensky about namely parabiosis (action antigens-allergens on the fabric, which was mentioned above).
When non-convulsive form eclampsia woman falls in severe and prolonged unconsciousness, which is caused by the sharp increase in intracranial pressure. Change intracranial pressure often leads to bleeding in the brain. Simultaneously, it is noted sweating, cyanosis, dyspnoea. Almost always strong vomiting, often observed even jaundice, pulse Ochsen, body temperature often raised. In urine detected grainy and hyaline cylinders, as well as red blood cells; the color of urine has vishnevogorsky color.
The mortality rate of women with eclampsia without convulsions, according to the literature of the past years, ranged from 66.6 per cent (C. A. lot, S. S. Kolmogorov) to 80% (C. S. Stroganov, L. A. Gusakov, and others). Currently, the death rate has dropped significantly, which is in close connection with timely implemented and properly selected preventive measures. A high death rate in the form of non-convulsive eclampsia due to large changes in the organism of the patient; for, as has been said, eclampsia is a condition of the organism as a whole and not to any individual organ or system. The changes, which are at autopsy in separate systems and organs (liver, kidneys and other), it is necessary to consider the phenomena of secondary origin.
The autopsy of the dead in the form of non-convulsive eclampsia shows that women are more likely to die from a brain hemorrhage on the grounds of changes in the walls of blood vessels. It is established that biogenic amines are the strongest vegetative poisons that affect the blood vessels.