On Labors Complicated with Convulsions

Robert Lee
1843 Boston Medical and Surgical Journal  
There is a striking resemblance between the symptoms observed in a case of common epilepsy and in one of puerperal convulsions, or eclampsia, as it is called by nosologists. In both these diseases insensibility takes place during the fits, and all the voluntary muscles of the face, trunk and extremities become convulsed. When a fit of puerperal convulsions comes on, the woman becomes perfectly unconscious of everything around her, and the muscles of the eyes and face are usually first affected.
more » ... lly first affected. Irregular spasmodic twitchings are observed about the mouth and eyelids, which produce great distortion of the countenance : the eyes are often turned upward and inward to the root of the nose, and roll rapidly about in different directions. The lower jaw is either firmly clenched against the upper, or it is drawn to one side ; and the tongue, being protruded between the teeth, is often severely lacerated. Every muscle, of the body soon becomes convulsed ; the spasm is violent and universal ; the respiration, which is at first hurried, afterwards becomes slow and stertorous, as the convulsions subside ; and a quantity of frothy saliva, tinged with blood, is blown from the mouth with a peculiar noise, as in an ordinary epileptic, fit. Sometimes the muscles on one side of the face and body only are at first affected ; and after the spasm has ceased in them, those on the opposite side become convulsed. The pupils of the eyes are usually dilated and insensible during a fit of puerperal convulsions ; but in some women, both between and during the paroxysms, they are closely contracted. The pulse varies extremely, being either very hurried, or slower than natural. After the convulsion has endured for a longer or a shorter period, as in cases of epilepsy, it gradually ceases ; and the patient, apparently greatly exhausted, is left in a state of deep stupor, with stertorous breathing. The consciousness generally does not return before another fit takes place ; and this happens, in the greater number of instances, in a short period, when the same phenomena are observed. A great number of violent fits are often experienced by some women during many hours, at longer or shorter intervals, without any return of sensibility. The attacks may terminate in a state resembling apoplexy, as epilepsy sometimes does, which may soon prove fatal ;
doi:10.1056/nejm184308300290401 fatcat:nigzwzksbrgalat6zxypiv732m