Puerperal Convulsions. Eclampsia.
DURING the latter part of pregnancy, and even during the lying in period a pregnant woman may be suddenly seized with a convulsion from which she may never recover consciousness. These fits generally last a few minutes, and complete consciousness follows with a terrific headache; from one to a hundred more attacks may ensue. The urine usually is found heavily loaded with albumen, and contains all the evidences of serious kidney disease.
Causes. These disorders are supposed to be due to the pressure on the kidneys and its vessels by the increasing growth of the child. Some cases, however, remain still unsatisfactorily explained.
To avoid any such sudden surprises women should have their urine examined every week or two in the latter part of pregnancy.
Symptoms. The disease is usually ushered in by some slight frontal headache, by swelling of the feet, ankles and eyelids; these are symptoms of impending trouble, and precautions should at once be taken to ward off the consequent disease. The urine becomes scanty, thick and smoky; the face or eyelids twitch, and soon the fit comes on, super induced by the large amount of urea retained in the blood in consequence of the crippled condition of the kidneys, which normally throw off these poisonous products.
Treatment. In most cases the womb must be immediately emptied of the child and pressure thus moved from the kidneys, which are stimulated to secrete freely. The fits are for the time being controlled by the inhalation of ether or chloroform. Bleeding, the free use of veratrum viride, and the use of chloral or even morphine will materially aid the case toward recovery.
Sweating the patient will many times turn the tide in favor of recovery. Covering the body with hot wet sheets and over these several dry blankets may be placed. It is advisable to keep the head cool by means of cold cloths or an ice bag. A subcutaneous injection of apomorphine given in 1 -10 gr. dose will start the perspiration. The hot air bath by means of a kerosene or alcohol lamp under a stovepipe funnel bent at a right angle over the foot of the bed is another valuable means to accomplish the same result. The temperature of the heated air should be 110 to 115' and the patient gradually cooled off after twenty to thirty minutes perspiration.
It is a very fatal disorder if left to itself, the patient not infrequently dying in the first convulsion, after prolonged unconsciousness
Here again the early discovery of the disease will often be sufficient to turn the tide in a favorable direction.
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