E

eclampsia A potentially life-threatening compli-
cation of PREGNANCYin which the woman experi-
ences tonic–clonic seizures, extreme HYPERTENSION
(high BLOOD PRESSURE), and periods of uncon-
sciousness or COMA. Eclampsia threatens the well-
being of the FETUSbecause it so dramatically affects
the mother’s health that prompt delivery is usu-
ally necessary, risking preterm birth when eclamp-
sia occurs before 37 weeks gestation.
Routine PRENATAL CARE, which allows early
detection of problems such as hypertension in the
pregnancy, and aggressive treatment for
PREECLAMPSIA, which is often though not always
the precipitating condition, make eclampsia rela-
tively uncommon in the United States. When it
does occur, eclampsia usually develops between
the 20th week of pregnancy and the first week
after CHILDBIRTH(though sometimes occurs up to
several weeks later).
Doctors do not know what causes eclampsia or
what causes some women who have preeclampsia
(sometimes called toxemia of pregnancy or gesta-
tional hypertension) to progress to eclampsia and
others not. The treatment of choice for eclampsia
is intravenous magnesium sulfate to stop the
seizures with delivery of the baby as rapidly as
possible. When eclampsia occurs before fetal via-
bility (generally 24 weeks), doctors may attempt
to control the hypertension and seizures in the
mother to allow the fetus to further mature. How-
ever, the best outcomes for mother and baby
occur with the earliest intervention possible.
There are no known measures to prevent eclamp-
sia.
See also GESTATIONAL DIABETES; SEIZURE DISORDERS.

ectopic pregnancy A life-threatening circum-
stance in which a fertilized ovum (ZYGOTE) implants

in a location outside the UTERUS, usually in one of

the FALLOPIAN TUBESthough sometimes elsewhere in

the abdominal cavity. A woman’s body cannot sup-

port such a PREGNANCY; if an ectopic pregnancy con-

tinues beyond the very early stages of development

it will cause the structure supporting (such as the

fallopian tube) it to rupture. The resulting hemor-

rhage (uncontrolled bleeding) becomes life-threat-

ening without treatment.

Symptoms and Diagnostic Path

Early symptoms of ectopic pregnancy typically

occur before the woman realizes she may be preg-

nant and mimic those of the onset of

MENSTRUATION. They may include

• cramping in the lower abdomen


• aching or PAINin the lower back


• NAUSEA
  
  
  • slight vaginal bleeding (spotting)
  
  
  
  

Many women do not experience early symp-

toms, however. The symptoms of ectopic preg-

nancy rapidly worsen, often over a period of

hours, progressing to sharp pain in the lower

abdomen and often shock and loss of CONSCIOUS-

NESS. Bleeding is usually internal, into the abdomi-

nal cavity, and consequently not apparent. The

diagnostic path typically includes PELVIC EXAMINA-

TION, BLOOD test for pregnancy, and abdominal

ULTRASOUND. The ultrasound can detect abnormal

tissues and bleeding.

Emergency medical care is essential for

symptoms of ectopic pregnancy. Ectopic

pregnancy cannot survive and is life-

threatening for the woman.

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