🎧 FREE MSRA PODCAST – Eclampsia: Rapid Recognition, Management & High-Yield Revision

Eclampsia is a true obstetric emergency. This episode distils the essentials – from recognising early warning signs to knowing the exact management steps, all UK-focused and mapped to the MSRA exam. Perfect for revision, on-call prep, or just building clinical confidence.

📝 Key Learning Points

📌 Definition & Epidemiology
• Eclampsia = seizures (or coma) in a pregnant woman with pre-eclampsia (hypertension + organ dysfunction after 20 weeks)
• UK incidence: rare (1 in 2,000–3,000 pregnancies), but high stakes
• Most cases develop before or during delivery, but can occur postpartum

📌 Causes & Risk Factors
• Rooted in abnormal placental development, leading to widespread vascular dysfunction
• High-risk:
 – First pregnancy
 – History of pre-eclampsia
 – Chronic hypertension or renal disease
 – Obesity
 – Multiple pregnancy (twins/triplets)

📌 Pathophysiology
• Placenta releases factors → blood vessel dysfunction (endothelial damage, leaky/constricted vessels)
• Result: hypertension, proteinuria, and risk of seizures

📌 Clinical Features
• Seizure (usually generalised tonic-clonic)
• Preeclampsia signs:
 – High BP (≥140/90 mmHg) after 20 weeks
 – Proteinuria (>300mg/24hr)
• Warning symptoms:
 – Severe headache
 – Visual disturbance (flashing lights, blurred vision)
 – Upper right abdominal pain
 – Oedema (hands/face/legs)

📌 Differential Diagnosis
• Epilepsy, cerebral haemorrhage, CNS infection, hypoglycaemia, drug-induced seizures, migraine

📌 Diagnosis & Investigations
• Clinical diagnosis: seizure + features of preeclampsia
• Bloods: LFTs, U&Es, clotting
• Urinalysis: proteinuria
• Fetal assessment: ultrasound, CTG

📌 Management (UK/NICE approach)
• Urgent delivery = definitive treatment (regardless of gestation)
• Magnesium sulfate:
 – Prevents and treats seizures
 – Bolus IV, then continuous infusion
 – Monitor reflexes, respiration, urine output
 – Antidote for toxicity: calcium gluconate
• BP control: antihypertensives
• Fluid restriction: prevent overload
• Multidisciplinary team care

📌 Prognosis & Complications
• Prompt management → good outcomes
• Complications if severe or untreated:
 – Maternal: stroke, liver/kidney injury, death
 – Fetal: placental abruption, preterm delivery, growth restriction, hypoxia
 – Maternal mortality: now rare, but possible

📎 More Eclampsia Revision Resources:
📝 Revision Notes: https://www.passthemsra.com/topic/eclampsia-revision-notes/
🧠 Flashcards: https://www.passthemsra.com/topic/eclampsia-flashcards/
💬 Accordion Q&A: https://www.passthemsra.com/topic/eclampsia-accordion-qa-notes/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/eclampsia-rapid-quiz/
🧪 Quiz Bank: https://www.passthemsra.com/quizzes/eclampsia/
🎓 Full Course: https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/

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