Eclampsia not limited  to TV or history

Photo by Joss Barratt for Masterpiece Classic on PBS -- Jessica Brown Findlay, left, as Lady Sybil and Allen Leech as Tom Branson share only a short time with their newborn daughter in the Jan. 27 episode of the PBS series 'Downton Abbey.' Lady Sybil's character succumbs shortly after the delivery to a condition called eclampsia, one which doctors continue to monitor their patients for today.
Photo by Joss Barratt for Masterpiece Classic on PBS -- Jessica Brown Findlay, left, as Lady Sybil and Allen Leech as Tom Branson share only a short time with their newborn daughter in the Jan. 27 episode of the PBS series 'Downton Abbey.' Lady Sybil's character succumbs shortly after the delivery to a condition called eclampsia, one which doctors continue to monitor their patients for today.

Followers of the popular British TV series “Downton Abbey” were stunned in a recent episode by the death of the youngest of the aristocratic Crawley daughters.

Lady Sybil Branson, played by Jessica Brown Findlay, died suddenly from a condition called eclampsia, which can follow a serious complication of pregnancy, shortly after she gave birth to a baby girl.

The third season of “Downton Abbey,” seen on LPB at 8 p.m. Sundays through Feb. 17, is set in the early 1920s

Preeclampsia, pregnancy-induced hypertension, remains a potentially dangerous complication for women that obstetricians-gynecologists carefully monitor for throughout pregnancy. Eclampsia is a condition that can follow severe preeclampsia and can bringing life-threatening seizures, according to the National Institutes of Health.

For some women, milder preeclampsia can be managed with bed rest and frequent checkups with the physician, according to the Preeclampsia Foundation, at its website, http://www.
preeclampsia.org
.

“Typically, we see the less severe” preeclampsia, said Dr. Amy Young, chair of the Department of Obstetrics and Gynecology at LSU Health Sciences Center, New Orleans.

“If the baby’s not term, we just watch the mom — if she gets sicker, we have to deliver — we watch and wait,” Young said.

“It’s a pretty delicate balance,” she said. “Each patient is different.”

A woman with severe preeclampsia will be admitted to the hospital. Inducing labor early or performing a cesarean section are recommended if the health of the mother or baby is at risk, according to the Preeclampsia Foundation.

A woman with severe preeclampsia can be administered medicines to control blood pressure and prevent seizures, Young said.

Steroid injections, given to the mother after 24 weeks of pregnancy, can also be given to speed up the development of the baby’s lungs, Young said. “The only way to cure preeclampsia is to deliver the baby.”

There’s no known way to prevent preclampsia, Young said.

Screenings are given to pregnant women as part of their routine visits, she said.

The patient is checked for rapid weight gain, and blood-pressure checks and urine screenings to detect protein are also part of the screening, Young said.

“Preeclampsia is a disease that is related to high blood pressure and increased protein output in the urine ... it affects the bone marrow, brain and liver,” Young said. “The way the disease manifests can vary from patient to patient.

“It’s a disease we don’t really know the cause of, even to this day,” Young said. Researchers and physicians “have been looking for (the cause) for a long time ... we think it happens very early in pregnancy when the placenta is formed.”

Preeclampsia, which typically appears after the 20th week of pregnancy, does seem to arise more often for women having their first pregnancy or a multiple pregnancy and for very young mothers and older mothers, Young said.

Other possible causes include autoimmune problems, problems with blood vessels, diet and genes, according to the National Institutes of Health.

A history of diabetes, high blood pressure or kidney disease is another risk factor, Young said.

For that latter reason, physicians see more incidents of preeclampsia in Louisiana, which has high rates of the above health conditions, she said.

Women who have preeclampsia often don’t feel sick early in the illness, according to the NIH.

Symptoms can include swelling of the hands, face and/or eyes — some swelling of the feet and ankles is considered normal — and sudden weight gain over a few days, it reports.

Symptoms of severe preeclampsia can include a headache that doesn’t go away; belly pain on the right side, below the ribs; irritability; decreased urine output; nausea and vomiting; and vision changes, according to the NIH.

If undetected, preeclampsia can lead to eclampsia, one of the top five causes of maternal and infant illness and death, according to the Preeclampsia Foundation, based in Melbourne, Fla.

The mortality rate for women in childbirth has dropped dramatically in the U.S., since 1930, when the rate of death for a woman in labor was 1 in 100, Young said.

That rate is approximately 1 in 10,000 now, she said. The three top causes of childbirth-related death are hypertension-related conditions, such as preeclampsia; C-sections and hemorrhage, Young said.

Symptoms of preeclampsia usually go away six weeks after delivery, she said.

But post-partum risks remain.

“Nearly 80 percent of women who die from preeclampsia die postpartum,” according to the Preeclampsia Foundation.

“Sleep deprivation, postpartum depression, more attention on the newborn and lack of familiarity with normal postpartum experiences all contribute to more easily ignoring or missing indicators of a problem,” said Eleni Tsigas, executive director of the Preeclampsia Foundation.