Eclampsia-An Emergent Condition: Pathophysiology, Diagnosis, Maternal-Fetal Outcomes, and Evidence-Based Management in Hypertensive Pregnancy Disorders

Background: Eclampsia, a life-threatening obstetric emergency characterized by seizures in pregnant or postpartum women with hypertensive disorders, remains a leading cause of maternal and perinatal morbidity and mortality. Despite advances in obstetric care, its pathophysiology—rooted in endothelial dysfunction, cerebral autoregulation failure, and blood-brain barrier disruption—is not fully understood. This review synthesizes current evidence on eclampsia’s etiology, diagnostic challenges, and evidence-based management to improve maternal-fetal outcomes. Methods: A comprehensive analysis of peer-reviewed studies, clinical guidelines, and epidemiological data was conducted, focusing on risk factors, diagnostic criteria, and therapeutic interventions. Results: Eclampsia affects 0.3% of pregnancies globally, with higher incidence in low-resource settings. Key risk factors include chronic hypertension, primigravidity, and obesity. Diagnosis hinges on clinical presentation (seizures ± hypertension/proteinuria), though 20% of cases lack classic preeclampsia features. Magnesium sulfate is the gold standard for seizure prophylaxis and treatment, reducing recurrence by 50%. Antihypertensives (labetalol, hydralazine, nifedipine) mitigate end-organ damage. Delivery is definitive therapy, with mode determined by maternal-fetal stability. Complications include HELLP syndrome (10–20% of cases), placental abruption, and long-term cardiovascular risks. Conclusion: Early recognition, prompt magnesium sulfate administration, and timely delivery are critical to improving outcomes. Multidisciplinary care, postpartum monitoring, and patient education on future pregnancy risks are essential. Future research should focus on biomarkers for early prediction and tailored therapies.