Loss of Consciousness Due to Eclampsia

Abstract

This case report aimed to describe the clinical manifestations of decreased consciousness in patients with antepartum eclampsia, evaluate the medical and obstetric management provided, and review the clinical implications of eclampsia on maternal and perinatal outcomes. A 28-year-old woman, G1P0A0, at 33 weeks of gestation presented to the emergency department with two episodes of generalized tonic-clonic seizures occurring within 3 hours before admission. The seizures were preceded by severe headache, epigastric pain, and visual disturbances, followed by decreased consciousness with a Glasgow Coma Scale (GCS) score of 12. The patient had no previous history of hypertension, epilepsy, or chronic disease, and blood pressure measurements during previous antenatal visits were reported to be normal. On examination, her blood pressure was 151/103 mmHg, with +3 proteinuria. The patient was diagnosed with decreased consciousness et causa antepartum eclampsia. She received magnesium sulfate therapy, antihypertensive treatment, and supportive care. Due to the unstable maternal condition, preterm gestational age, and fetal status, pregnancy termination was performed through cesarean section. The newborn had a very low birth weight and was admitted to the neonatal intensive care unit (NICU). Seizures in eclampsia are associated with cerebral vasospasm, cerebral edema, and impaired autoregulation of cerebral blood flow, which may lead to decreased consciousness. The primary management approach focuses on maternal stabilization, with magnesium sulfate as the anticonvulsant of choice and blood pressure control as essential components of therapy. Delayed treatment may increase the risk of multisystem complications and maternal and perinatal mortality. Eclampsia is an obstetric emergency that requires prompt diagnosis and immediate management.