Lady Sybil

How tragic to see the lovely Lady Sybil lose her life to such a treatable illness, eclampsia in last nights episode of Downton Abbey. I’m sure for those who watched it found it just as difficult to see her family witness her having an eclamptic fit whilst the family doctor watched on in horror as there was nothing he could do to save her. Luckily in this day and age, pre-eclampsia is a managable condition and with the right detection and diagnosis situations such as these are extremely rare.

Pre-eclampsia is a condition that only occurs during pregnancy. It causes high blood pressure and it also causes protein to leak from your kidneys into your urine. This can be detected by testing your urine for protein. Pre-eclampsia usually comes on sometime after the 20th week of your pregnancy and gets better within six weeks of you giving birth. The severity can vary. Pre-eclampsia can cause complications for you as the mother, for your baby, or for both of you. The more severe the condition becomes, the greater the risk that complications will develop. Somewhere between 2 and 8 in 100 pregnant women develop pre-eclampsia.

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.

Your midwife will want you to produce a urine sample at every antenatal appointment

She will also check your blood pressure

And measure the fundal height of your bump

The severity of pre-eclampsia is usually (but not always) related to your blood pressure level. You may have no symptoms at first, or if you only have mildly raised blood pressure and a small amount of protein in your urine. If pre-eclampsia becomes worse, one or more of the following symptoms may develop. Contact your midwife urgently if any of these occur:

  • Severe headaches that do not go away.
  • Problems with your vision, such as blurred vision, flashing lights or spots in front of your eyes.
  • Abdominal (tummy) pain. The pain that occurs with pre-eclampsia tends to be mainly in the upper part of your abdomen, just below your ribs, especially on your right side.
  • Vomiting later in your pregnancy (not the morning sickness of early pregnancy).
  • Sudden swelling or puffiness of your hands, face or feet.
  • Not being able to feel your baby move as much.
  • Just not feeling right.

In the case of Lady Sybil, many opportunities were missed by the family doctor, Dr Clarkson to detect pre-eclampsia. She was heard complaining of abdominal pain, swollen ankles and a serve headache despite her doctor quoting ‘Lady Sybil is just a healthy young woman going through a very natural process.’ However medicine has moved on from the post Edwardian era and pre-eclampsia is much more widely known and understood. for more information click here.

P.s did anyone notice the nurse present at the birth as the doctors aid and not a midwife?! Shame on you ITV, bring on Series 2 of Call the Midwife!

7 thoughts on “Pre-Eclampsia

  1. sorry but pre-eclampsia is NOT TREATABLE. You should be aware of this in your profession – why don’t you? The only option is to deliver the baby – if there is early onset pre-clampsia then the baby will die as happened to me. 10 years on the research is no further on. There is a test to check if you will develop the condition, but no treatment and no cure.

    • I’m sorry that you suffered from these terrible circumstances and you lost your baby. The reason why I write these posts is the raise awareness and open up discussions. The treatment I was referring to is antihypertensives (calcium blockers) and magnesium sulphate in extreme cases when it develops into eclampsia. Scans during pregnancy can detect uterine artery notching which along side the other symptoms mentioned in this post can be an indication of the early onset of pre-eclampsia. In some cases when HELLP develops, extreme IUGR and uncontrollable high blood pressure, yes delivery of the baby is the only option. However this (and in the Downton Abbey story) does not mean that the mother is out of the woods. As found in the Magpie trial 40% of seizures occurred in the postnatal period. I hope this answers your questions.

  2. Both doctors were useless. Sir Philip and Dr. Clarkson should both have known about magnesium sulphate as a treatment for eclampsia convulsions, first used in 1906.

  3. I agree with previous poster that pre-eclampsia cannot be considered “a treatable condition”; while there are measures to detect it, there is little current medicine can do to “treat” or stop it from taking the lives of babies and endangering mothers. The women I know who lost their precious babies due to premature births prompted by pre-clampsia were diagnosed and being “treated.” It is probably true that it is rare for the condition to take the lives of mothers these days, but not for it to cause extreme prematurity that allows the babies little chance of survival. As a mother who had lost an infant (to another unrelated medical issue), I cannot accept the death of a baby as a successful treatment.

    Also, a less important correction: it was the visiting London doctor, Sir Philip, who repeatedly dismissed Lady Sybil’s early symptoms. The family doctor, Dr Clarkson, had diagnosed her correctly, but his advice was tragically ignored by Lord Grantham. Furthermore, I think in this case, it was not only about recognizing symptoms, but also about the dangers of being overly confident based on past experience, the importance of knowing the patient, not brushing off her complaints, and expecting everything to play out as in a textbook. I know from my own labor experience that mine was far from text book (4mm to fully dilated in under 10 minutes in my first, second, and third pregnancy).

    Anyway, I applaud your effort to educate the public, and this is a sensitive topic to many. I do think it is important, however, to check facts and balance encouragements/optimism with accurate/complete information. Personally, it was shocking to me when I lost my child, because infant mortality is a statistic our society does not like to dwell on, not even (and perhaps, especially not) within the medical community.

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