Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia. Pre-eclampsia is a hypertensive disorder of pregnancy that presents with three main features: new onset of high blood pressure, large amounts of protein in the urine or other organ dysfunction, and edema. If left untreated, pre-eclampsia can result in long-term consequences for the mother, namely increased risk of cardiovascular diseases and associated complications. In more severe cases, it may be fatal for both the mother and the fetus. The diagnostic criteria for pre-eclampsia is high blood pressure occurring after 20 weeks gestation or during the second half of pregnancy. Most often it occurs during the 3rd trimester of pregnancy and may occur before, during, or after delivery. The seizures are of the tonic–clonic type and typically last about a minute. Following the seizure, there is either a period of confusion or coma. Other complications include aspiration pneumonia, cerebral hemorrhage, kidney failure, pulmonary edema, HELLP syndrome, coagulopathy, placental abruption and cardiac arrest.
Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the onset of high blood pressure and often a significant amount of protein in the urine. When it arises, the condition begins after 20 weeks of pregnancy. In severe cases of the disease there may be red blood cell breakdown, a low blood platelet count, impaired liver function, kidney dysfunction, swelling, shortness of breath due to fluid in the lungs, or visual disturbances. Pre-eclampsia increases the risk of undesirable as well as lethal outcomes for both the mother and the fetus including preterm labor. If left untreated, it may result in seizures at which point it is known as eclampsia.
Gestational hypertension or pregnancy-induced hypertension (PIH) is the development of new hypertension in a pregnant woman after 20 weeks' gestation without the presence of protein in the urine or other signs of pre-eclampsia. Gestational hypertension is defined as having a blood pressure greater than 140/90 on two occasions at least 6 hours apart.
Complications of pregnancy are health problems that are related to, or arise during pregnancy. Complications that occur primarily during childbirth are termed obstetric labor complications, and problems that occur primarily after childbirth are termed puerperal disorders. While some complications improve or are fully resolved after pregnancy, some may lead to lasting effects, morbidity, or in the most severe cases, maternal or fetal mortality.
Intrauterine hypoxia occurs when the fetus is deprived of an adequate supply of oxygen. It may be due to a variety of reasons such as prolapse or occlusion of the umbilical cord, placental infarction, maternal diabetes and maternal smoking. Intrauterine growth restriction may cause or be the result of hypoxia. Intrauterine hypoxia can cause cellular damage that occurs within the central nervous system. This results in an increased mortality rate, including an increased risk of sudden infant death syndrome (SIDS). Oxygen deprivation in the fetus and neonate have been implicated as either a primary or as a contributing risk factor in numerous neurological and neuropsychiatric disorders such as epilepsy, attention deficit hyperactivity disorder, eating disorders and cerebral palsy.
Lydia Rabinowitsch-Kempner was a Jewish bacteriologist and physician, known for her research on tuberculosis and public health. She was the second woman to become a Professor in Prussia.
Orthostatic hypertension is a medical condition consisting of a sudden and abrupt increase in blood pressure (BP) when a person stands up. Orthostatic hypertension is diagnosed by a rise in systolic BP of 20 mmHg or more when standing. Orthostatic diastolic hypertension is a condition in which the diastolic BP raises to 98 mmHg or over in response to standing, but this definition currently lacks clear medical consensus, so is subject to change. Orthostatic hypertension involving the systolic BP is known as systolic orthostatic hypertension.
A high-risk pregnancy is one where the mother or the fetus has an increased risk of adverse outcomes compared to uncomplicated pregnancies. No concrete guidelines currently exist for distinguishing “high-risk” pregnancies from “low-risk” pregnancies; however, there are certain studied conditions that have been shown to put the mother or fetus at a higher risk of poor outcomes. These conditions can be classified into three main categories: health problems in the mother that occur before she becomes pregnant, health problems in the mother that occur during pregnancy, and certain health conditions with the fetus.
Hypertensive disease of pregnancy, also known as maternal hypertensive disorder, is a group of high blood pressure disorders that include preeclampsia, preeclampsia superimposed on chronic hypertension, gestational hypertension, and chronic hypertension.
Lesley Margaret Elizabeth McCowan is a New Zealand medical researcher and academic specialising in maternal health. She is currently a full professor and head of obstetrics and gynaecology at the University of Auckland.
Irene Mary Carmel Tracey is Vice-Chancellor of the University of Oxford and former Warden of Merton College, Oxford. She is also Professor of Anaesthetic Neuroscience in the Nuffield Department of Clinical Neurosciences and formerly Pro-Vice-Chancellor at the University of Oxford. She is a co-founder of the Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), now the Wellcome Centre for Integrative Neuroimaging. Her team’s research is focused on the neuroscience of pain, specifically pain perception and analgesia as well as how anaesthetics produce altered states of consciousness. Her team uses multidisciplinary approaches including neuroimaging.
Marian Knight is a British physician who is a Professor of Maternal and Child Population Health at the University of Oxford. She is an Honorary Consultant of Public Health for Public Health England. During the COVID-19 pandemic Knight studied the characteristics and outcomes of pregnant women who tested positive for COVID-19.
Caroline Susan E. Homer is an Australian midwifery researcher and international advocate for women's health rights. She is Co-Program Director, Maternal and Child Health at the Burnet Institute in Melbourne and Visiting Distinguished Professor of Midwifery at the University of Technology Sydney.
Chaniece Wallace, a black woman and physician, died at 30 years of age from complications of pregnancy two days after giving birth. Her death is seen as preventable and is viewed in the context of high rates of maternal mortality in the United States, particularly among the African American population. It is cited as an example in medical and scholarly publications to call for improved health outcomes in the black U.S. population. Wallace died despite several factors seen as protective: she was "highly educated, employed as a health care practitioner, had access to health care, and had a supportive family."
Maternal health outcomes differ significantly between racial groups within the United States. The American College of Obstetricians and Gynecologists describes these disparities in obstetric outcomes as "prevalent and persistent." Black, indigenous, and people of color are disproportionately affected by many of the maternal health outcomes listed as national objectives in the U.S. Department of Health and Human Services's national health objectives program, Healthy People 2030. The American Public Health Association considers maternal mortality to be a human rights issue, also noting the disparate rates of Black maternal death. Race affects maternal health throughout the pregnancy continuum, beginning prior to conception and continuing through pregnancy (antepartum), during labor and childbirth (intrapartum), and after birth (postpartum).
Murielle Bochud is a Swiss physician who is the co-chief of the Department of Epidemiology and Health Systems at the Unisanté in Lausanne. Her research considers the epidemiology of cardio-metabolic diseases and genetic epidemiology.
Lucy Chappell is a British professor of obstetrics at King’s College London and the Chief Scientific Adviser (CSA) for the UK Department of Health and Social Care. As part of her CSA role, she oversees the National Institute for Health and Care Research (NIHR) as Chief Executive Officer. Her research areas include medical problems during pregnancy such as pre-eclampsia, and the safety of medicines in pregnancy.
SallyAnn Harbison is a New Zealand forensic scientist. She leads the forensic biology team at the Institute of Environmental Science and Research, and is an associate professor at the University of Auckland. Harbison was appointed a Member of the New Zealand Order of Merit in 2021 and in the same year was elected as a Fellow of the Royal Society Te Apārangi.
Sonja Jayne McIlfatrick is a nurse and Professor in Nursing and Palliative Care and Dean of Ulster Doctoral College at Ulster University. She was the first non-American President of the International Network of Doctoral Education in Nursing.
Annettee Olivia Nakimuli is a Ugandan obstetrician, gynecologist, medical researcher, academic and academic administrator. Since 17 February 2021, she serves as the Dean of Makerere University School of Medicine, the oldest medical school in East Africa. She concurrently serves as the Head of Department of Obstetrics and Gynecology at the same medical school, a role she has served in since 2016. She is also the President of the East, Central and Southern Africa College of Obstetrics and Gynecology.
