'Downton Abbey' exposes pregnancy disease

Don't mess with "Downton Abbey" fans. That became clear after last week's stunner episode, featuring eclampsia, a dangerous pregnancy disorder. Fans of the PBS series immediately hit Facebook and Twitter in droves, outraged by an unexpected plot twist. And asking, "What is eclampsia?"

Nine days later, that question has doctors and health experts rather pleased.

"Yes, it's a historical drama, but that episode turned into a public health message," says Eleni Tsigas, executive director of the Preeclampsia Foundation, based in Melbourne, Fla. Hours after the episode aired, hits on the foundation's website doubled. A day later, they'd tripled. Facebook "likes" increased sixfold.


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"It was emotional, because women today are still dying from that and other forms of the disease," says Tsigas.

So what do you need to know about eclampsia and the related disorder, pre-eclampsia?

Pre-eclampsia is a mysterious condition striking up to 8 percent of pregnant women in the United States, usually late in the second or third trimester, resulting in severe hypertension, and often sudden swelling of extremities and protein in the urine. Other symptoms include headaches and blurry vision. Blood vessel spasms are to blame, but doctors don't know what causes that.

"You have to be on the lookout," says Dr. Jill M. Rabin, professor of obstetrics and gynecology at Hofstra North Shore-LIJ School of Medicine.

Magnesium sulfate stabilizes patients until they can deliver. But unchecked, pre-eclampsia can advance to eclampsia, when seizures strike, often leaving the woman comatose or dead.

That's what happened to "Downton's" Lady Sybil Branson, who showed textbook warning signs, such as swollen ankles and albumin in her urine. Her local country doctor noticed this and warned Sybil and her family, fearing she had "toxemia," the term used during the 1920s, when the series is set. But another, prominent physician dismissed such concerns. Sybil had her baby, fell into convulsions and died.

Seizures often strike shortly after delivery, although some occur up to six weeks postpartum.

Doctors today are much more informed and vigilant about this than physicians in the 1920s, Rabin notes. "As people saw last week, it's important to not be afraid to ask your doctor questions," says Rabin.

"Medical practice has evolved -- we've come light-years from that era," she added. "Most near misses are due to a communication problem," says Rabin. "If we ask the right questions, and you're willing to talk to us, we can reduce those misses -- just by listening to each other."

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