[Eclampsia].

Abstract

Eclampsia is the most serious manifestation of a toxaemic encephalopathy which may also have nonconvulsive manifestations, such as headache, visual disorders or retinal or cortical origin, confusion or disturbances of consciousness. Some authors consider eclampsia as being only one particular aspect of hypertensive encephalopathy. However, recent studies have drawn attention to the importance of angiospasm which might not be a pure reaction to hypertension but might result from a relative deficiency in vascular prostacyclin. These physiopathological factors, to which must sometimes be added disseminated intravascular coagulation, account for computerized tomographic and neuropathological findings showing cerebral oedema and, in complicated cases, ischaemic or haemorrhagic lesions. Medical treatment must rapidly control the convulsive attacks as well as the arterial hypertension. Magnesium sulfate is not much used outside the United States where it is now strongly controverted. The obstetrical management depends on the time when eclampsia occurs and on the efficacy of the medical treatment.