Fig. 103.—The improvised Trendelenburg position. (American Text Book.)
The prodromal symptoms have already been described under albuminuria in pregnancy (p. [77]). The marked features may be repeated for emphasis: persistent headaches, disorders of vision, spots before the eyes, blindness, edema of cheeks, eyelids, feet and hands, pain at the pit of the stomach, dizziness, nausea and vomiting and ringing in the ears. Suddenly the convulsion occurs, the facial muscles twitch, then the limbs and body are shaken by violent muscular spasms. The body becomes rigid, the tongue protrudes and the face is livid and cyanotic. The spasm usually lasts from one to five minutes and is succeeded by coma that lasts an hour or more. In some instances there is no return to consciousness before the next attack, which comes on every hour or half hour, though occasionally only one seizure is noted.
Fig. 104.—The dorsal position with stirrups. (Dorland’s Dictionary.)
The blood pressure is greatly increased and the urine is diminished, the temperature rises to 101° or 102° F. When death ensues, it is most frequently due to edema of the lungs or cerebral hæmorrhage.
The greater the number of convulsions, the more serious the outlook as to life, and it is said that after twenty seizures fifty per cent of the mothers die. Under the best treatment approximately fifty per cent of the babies die.
Fig. 105.—Dorsal position across the bed. (Bumm.)
There is no routine treatment for eclampsia.
The principles of management for the attack are (1) to empty the uterus, on the theory that the disease is a toxæmia of gestational origin, (2) to eliminate the poison, and (3) to control the convulsions.