A 27-year-old primigravida at 32 weeks' gestation with a documented history of pre-eclampsia suddenly becomes unresponsive and exhibits a generalized tonic-clonic seizure lasting about 60 seconds. After ensuring airway patency and maternal safety, which obstetric complication should the nurse suspect the client has developed?
The correct answer is eclampsia. Eclampsia is diagnosed when a client with pre-eclampsia experiences one or more unexplained seizures. Seizure activity signals central-nervous-system involvement and represents a life-threatening escalation of the disease.
Why the other options are incorrect:
HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) can occur with pre-eclampsia but is characterized by laboratory abnormalities and right-upper-quadrant pain rather than seizures.
Placental abruption involves premature separation of the placenta, typically presenting with vaginal bleeding and abdominal pain.
Amniotic fluid embolism is a rare, catastrophic event marked by sudden cardiovascular collapse and disseminated intravascular coagulation, not isolated tonic-clonic seizures.
Prompt recognition of eclampsia is essential so that magnesium sulfate can be administered to control seizures and preparations can be made for expedient delivery if maternal or fetal status deteriorates.
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