Intensive care management of women with eclampsia

Eklampsija je po život opasno stanje, ne samo za trudnicu, već i za njeno nerođeno dijete. Poznata je još od doba Hipokrata, od koga datira i prvi opis ovoga stanja. Sam naziv „eklampsija“ dolazi od grčke riječi za izraz bljesnuti, kojim se nastojala objasniti iznenadna pojava konvulzija. Eklampsija se definira kao pojava konvulzija, najčešće pred porod, u trudnica sa simptomima preeklampsije, odnosno hipertenzijom i proteinurijom nastalima nakon 20. tjedna gestacije. Prema tome, bez preeklampsije nema ni eklampsije, tako da se eklampsija može smatrati progresijom same preeklampsije, a ne toliko zasebnim entitetom. Konvulzije koje se javljaju u eklampsiji su toničko – kloničkog tipa i obično traju jednu minutu. Brojne su komplikacije vezane uz eklampsiju, kao što su aspiracijska pneumonija, moždano krvarenje, zatajenje bubrega i srčano zatajenje. Preeklampsija i eklampsija dio su veće grupe poznate kao hipertenzivni poremećaji u trudnoći. U liječenju eklampsije primarno je zaustaviti konvulzije, što se postiže davanjem magnezijevog sulfata, a nakon toga je nužno stabilizirati krvni tlak antihipertenzivnim lijekovima. Usprkos svih napredaka u medicini i svih modernih tehnologija i terapija na raspolaganju, u slučaju eklampsije, jedina konačna terapija je porod. I dan danas, eklampsija je važan uzrok smrtnosti majki, ali i djece u svijetu. Kao što se može vidjeti, brojni su izazovi stavljeni pred liječnike koji skrbe o bolesnicama s eklampsijom, jedan od kojih je i činjenica da se, osim za ženu, moraju brinuti i za zdravlje i dobrobit njenog djeteta.Eclampsia is a life – threatening disease, which affects not only the mother, but her unborn child as well. We have known about it since the time of Hippocrates, who was the first to describe this condition. The word „eclampsia“ derives from the Greek term for lightening, attempting to explain the abrupt onset of convulsions. Eclampsia is defined as the onset of convulsion, mostly antepartum, in women with sympthoms of pre-eclampsia, meaning with hypertension and proteinuria that occured after the 20th week of gestation. Accordingly, without pre-eclampsia there is no eclampsia, therefore it can be regarded as progression of pre-eclampsia, rather than its own entity. The seizures that occur in eclampsia are of clonic – tonic type and they usually last for one minute. Numerous complications, like aspiration pneumonia, cerebral hemorrhage, kidney failure, and cardiac arrest, are associated with eclampsia. Preeclampisa and eclampsia are a part of a larger group of conditions known as hypertensive disorders of pregnancy. The primary goal in treating eclampsia is to stop seizures by administering magnesium sulfate, and afterwards to stabilize the blood pressure with an antihypertensive therapy. Despite all the progress made in medicine, and all of modern tehnologies and therapy options, when considering eclampsia, the only definite treatment option is giving birth. Even now, eclampsia is an important cause of death amongst mothers, and newborns all around the world. As can be observed, there are many challanges that physicians who participate in the care of eclamptic women have to face, one of which is the fact that they have, not only the mother, but her childs' health and wellbeing to take care of as well