Eclampsia seizure is an always serious and potentially fatal obstetric condition. Safe delivery in women with pregnancies complicated by
eclampsia seizures is still one of the greatest challenges in perinatal medicine. Pregnancy should be terminated (childbirth) in the safest and least traumatic way possible. Attempting vaginal delivery can take place only exceptionally, in the event of possibly quick completion of childbirth with a stable state of the mother and the fetus. However, immediate labor via
cesarean section is most often recommended. It is essential to maintain left lateral
patient positioning during
cesarean section.
Regional anesthesia can be used only in conscious patients who are free from coagulopathy and from HELLP (
hemolysis, elevated liver
enzymes, and low platelet count) syndrome to decrease the risk of aspiration and failed intubation attempts in preeclamptic or eclamptic women. For sudden, unexpected interventions, when a patient arrives at the hospital with an
eclampsia seizure without lab results,
general anesthesia can be the best option and should be performed by an experienced medical team of anesthesiologists, ready to perform difficult intubation.
Magnesium sulfate is the drug that should be used first to stop eclamptic convulsions and prevent their recurrence. Intravenous
antihypertensive drugs can stabilize elevated blood pressure (BP), preventing multiorgan failure and recurrent
eclampsia seizure, and thus the prevention of
maternal death. This article aims to review the management of
seizures during pregnancy in women with
eclampsia to ensure safe delivery.