North American Registry of Midwives (NARM) Practice Exam

During which period are eclamptic seizures most likely to occur?

1. First trimester and early second trimester

2. Second trimester and early third trimester

3. Third trimester and during labor

4. Postpartum period

The correct answer is: Third trimester and during labor

Eclamptic seizures are most likely to occur during the third trimester and during labor due to the physiological changes that women experience during these times. As the pregnancy progresses, the risk factors for developing preeclampsia, a condition characterized by high blood pressure and potential organ failure, increase significantly. When preeclampsia is severe, it can lead to eclampsia, manifested by seizures. During the third trimester, the body is under increased stress, including heightened blood volume, vascular resistance changes, and potential placental dysfunction, all of which can contribute to the development of severe hypertension and eclamptic seizures. Additionally, the labor process itself can pose risks as women often experience significant physical stress, which can precipitate an eclamptic seizure in those with underlying conditions. The postpartum period can also be a time of concern for eclamptic seizures; however, the peak risk typically coincides with late pregnancy and labor. Therefore, the identified timeframe is consistent with clinical observations and guidelines regarding the risk factors associated with eclampsia. Understanding these periods is vital for monitoring and managing maternal health effectively during pregnancy and childbirth.