Eclampsia Grand mal seizures in a woman with preeclampsia Management of Eclampsia airway, breathing, circulation seizure control an...
Eclampsia
Grand mal seizures in a woman with preeclampsia
Management of Eclampsia
- airway, breathing, circulation seizure control and prevention
- do not attempt to shorten or abolish the initial convulsion
- prevent maternal injury and maintain adequate oxygenation
- minimize risk of aspiration, auscultate lungs after every seizure
- give adequate magnesium sulphate as soon as convulsion has ended
- correct maternal acidemia (obtain post-ictal blood gases)
- some use diazepam for seizure control
Chronic Hypertension
Features
- history of hypertension (> 140/90) before gestation
- detection of hypertension prior to 20 weeks gestation (unless there is a GTN)
- persistence of hypertension postpartum
- strong family history of hypertension
- most gravidas have essential hypertension, associated with an increased risk of preeclampsia or eclampsia, abruptio placenta, IUGR and IUD
- methyldopa and/or labetalol
- no ACE inhibitors, diuretics, propranolol
Chronic Hypertension with Superimposed Preeclampsia/ Eclampsia
- 2-7 fold increased likelihood of developing preeclampsia/ eclampsia if pre-existing maternal hypertension
- tends to recur
- occurs early in pregnancy, tends to be severe, often with IUGR
Transient or Gestational Hypertension
- hypertension alone that develops during the latter half of pregnancy or during the first 24 hours after delivery and disappears within 10 days following parturition
- monitor for signs of preeclampsia/eclampsia
