Eclampsia at Downton Abbey

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The pregnant daughter, Sybil, developed eclampsia after warning signs of pre-eclampsia were appreciated by the regular doctor but missed by the London consultant called in to provide care during the delivery. I am sure that many people have heard of pre-eclampsia, but how many know what eclampsia is?
When I first practised as a midwife, women with severe pre-eclampsia were nursed in a quiet, dark room with minimal stimulation. A midwife would stay in the room at all times until either delivery took place or the symptoms were controlled with medication. Pre-eclampsia can progress to eclampsia which causes the woman to fit. This can lead to significant problems for the woman and her baby.

'Eclampsia is a type of seizure (a fit or convulsion) which is a life-threatening complication of pregnancy. Less than 1 in 100 women with pre-eclampsia develop eclampsia. So, most women with pre-eclampsia do not progress to have eclampsia. However, a main aim of treatment and care of women with pre-eclampsia is to prevent eclampsia and other possible complications'. (
What people do not realise is that although delivering the baby reduces the risk of eclampsia, as with Sybil in Downton Abbey, there is still a risk of fits following delivery.'Once eclampsia develops, the only treatment is delivery of the baby (if eclampsia occurs prior to delivery). Eclampsia can also occur after delivery (up to 24 hours postpartum, typically). Rarely, eclampsia can be delayed and occur up to one week following delivery. There is no cure for eclampsia'. (eMedicineHealth)

Antenatal care is provided to all pregnant women. Clinicians are alert to the signs and symptoms of pre-eclampsia and medication is available to treat the symptoms. Unfortunately, Sybil, and woman of that time, did not have the benefit of such health care. We are very lucky to have such maternity care available in 2012.

Patricia Wakeford
Solicitor - Clinical Negligence team

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