Preeclampsia vs Eclampsia: Symptoms, Causes, Treatment & Prevention

Abstract

Preeclampsia and eclampsia are serious complications that can occur during pregnancy, particularly in low- and middle-income countries (LMICs). They are among the leading causes of maternal and neonatal morbidity and mortality globally. While they share many features, including high blood pressure and organ damage, eclampsia is the more severe form that includes seizures. This paper provides an in-depth yet easy-to-understand comparison of preeclampsia and eclampsia, exploring their similarities and differences, underlying pathophysiology, real-world cases, diagnostic criteria, and current treatment and prevention strategies. Our goal is to educate readers in Africa and around the world to recognize the warning signs early and take action, potentially saving lives.

Introduction

Pregnancy should be a joyful journey, a time of hope and celebration. But for many women around the world, especially in developing regions of Africa, Asia, and Latin America, it becomes a life-threatening experience due to complications like preeclampsia and eclampsia. According to the World Health Organization (WHO, 2023), preeclampsia and eclampsia contribute to approximately 14% of all maternal deaths worldwide. These conditions are not only dangerous for the mother but also for the unborn child, leading to premature birth, low birth weight, and stillbirth.

While they are connected by a shared path of progression, preeclampsia and eclampsia are different in their severity and outcomes. Understanding how they compare and contrast is essential for healthcare professionals, pregnant women, families, and communities.

Definitions

• Preeclampsia is a pregnancy-specific condition that usually starts after 20 weeks of gestation. It is characterised by high blood pressure (≥140/90 mmHg) and signs of damage to other organs, particularly the liver and kidneys (ACOG, 2020).
• Eclampsia is the progression of preeclampsia into a more dangerous state that includes seizures (convulsions) without any other neurological cause (Magee et al., 2022). Eclampsia is a medical emergency.

Real-World Scenario: A Story from Nigeria

Let’s consider the case of Grace, a 27-year-old first-time mother from rural Nigeria. In her sixth month of pregnancy, Grace began to experience headaches, blurred vision, and swelling in her legs. She thought it was just part of normal pregnancy changes. There was no nearby clinic, and her family didn’t realise the danger.

By the seventh month, Grace developed convulsions at home. She was rushed to the district hospital, where doctors diagnosed her with eclampsia. Unfortunately, the baby was lost, and Grace spent two weeks in intensive care. She survived but now educates other women about recognizing symptoms early.

This story is far too common—and largely preventable.

Pathophysiology (What Happens Inside the Body)

Preeclampsia and eclampsia begin with abnormal changes in the placenta—the organ that connects mother and baby. In a healthy pregnancy, blood vessels in the uterus transform to provide sufficient blood flow to the placenta. But in preeclampsia:

• These vessels remain narrow and stiff.
• As a result, the placenta doesn’t get enough blood (hypoperfusion).
• This triggers the release of substances into the mother’s bloodstream, causing widespread inflammation and damage to blood vessels.
• Blood pressure rises and organs like the kidneys, liver, brain, and eyes begin to suffer.

Eclampsia occurs when this process affects the brain severely enough to cause seizures. Swelling in the brain (cerebral edema) and disturbances in blood flow can trigger convulsions.

Risk Factors

Both preeclampsia and eclampsia share several risk factors:

• First pregnancy (primigravida)
• History of preeclampsia in previous pregnancy
• Multiple pregnancy (twins, triplets)
• Chronic hypertension or kidney disease
• Diabetes mellitus
• Family history
• Age (teenage mothers or those over 35)
• Obesity
• Low socioeconomic status and limited access to healthcare

(Ananth et al., 2021)

Symptoms: Compare and Contrast

Diagnosis

Preeclampsia is diagnosed through:

• Blood pressure measurement (≥140/90 mmHg on two occasions)
• Urinalysis (≥300 mg of protein in 24-hour urine)
• Blood tests to check liver enzymes and platelets
• Ultrasound for fetal growth

Eclampsia is diagnosed clinically when seizures occur in a woman with preeclampsia and no other neurological condition.

Treatment and Management

Preeclampsia:

• Mild cases may be managed with close monitoring, rest, and antihypertensive drugs (like labetalol).
• Severe cases may require hospitalization, magnesium sulfate to prevent seizures, and early delivery if the baby is mature enough.

Eclampsia:

• Immediate treatment with magnesium sulfate to stop and prevent seizures
• Stabilization of blood pressure
• Emergency delivery (often by caesarean section) regardless of gestational age to save the mother’s life
• Intensive care support

(World Health Organization, 2023)

Prevention Strategies

• Early and regular antenatal care
• Screening for high-risk women
• Low-dose aspirin for women with a history of preeclampsia (initiated before 16 weeks gestation)
• Calcium supplementation in areas where dietary calcium intake is low (like parts of sub-Saharan Africa)
• Public education campaigns

(ACOG, 2020; WHO, 2023)

Long-Term Effects

Women who had preeclampsia or eclampsia have a higher risk of developing:

• High blood pressure later in life
• Heart disease and stroke
• Kidney disease
• Diabetes

This highlights the importance of long-term follow-up and lifestyle interventions after delivery.

Global and African Perspectives

In developed countries, maternal deaths from eclampsia are rare due to early detection and treatment. However, in sub-Saharan Africa and South Asia, lack of access to care remains a challenge.

A study in Ghana (Bonsu et al., 2022) found that up to 60% of eclampsia cases presented as emergencies due to late recognition of preeclampsia signs. Training midwives and traditional birth attendants made a big difference in early referrals.

Comparative Summary

• Similarity: Both conditions involve high blood pressure and organ damage during pregnancy.
• Difference: Eclampsia includes seizures and is more life-threatening.
• Management: Preeclampsia may be managed conservatively; eclampsia needs emergency action.
• Outcome: Early detection can save both mother and child in both cases.

Conclusion

Preeclampsia and eclampsia are serious but preventable conditions. With proper antenatal care, public awareness, and timely treatment, we can reduce the risks and protect mothers and babies—especially in regions with limited healthcare access. Let us continue to educate, advocate, and support women like Grace so no one has to suffer or lose a child to a preventable cause.

References

American College of Obstetricians and Gynecologists (ACOG). (2020). Hypertension in pregnancy. https://www.acog.org/

Ananth, C. V., Keyes, K. M., & Wapner, R. J. (2021). Preeclampsia and risk of chronic disease. American Journal of Obstetrics and Gynecology, 224(1), 1-10.

Bonsu, F., Afari, H., & Osei-Kuffour, R. (2022). Community-level interventions for preeclampsia: Evidence from rural Ghana. African Journal of Reproductive Health, 26(3), 89–97.

Magee, L. A., Sharma, S., Nathan, H. L., Adetoro, O. O., & von Dadelszen, P. (2022). The management of hypertensive disorders in pregnancy in low-resource settings. International Journal of Gynaecology and Obstetrics, 159(S1), 25–32.

World Health Organization (WHO). (2023). WHO recommendations: Prevention and treatment of pre-eclampsia and eclampsia. https://www.who.int