ECLAMPSITA IN ENGLISH
watch my youtube video to understand this topic in easy way-
https://www.youtube.com/watch?v=2MWlhm8BepE
ECLAMPSIA-
Eclampsia is a neurological condition associated with preeclampsia,
manifesting with tonic-clonic convulsions in pregnancy that are not ssocited
with other conditions such as epilepsy
Eclampsia can develop any time from 20 weeks’ gestation up to 6 weeks
postpartum. It is an medical emergency and should be dealt with a team of
physician and gynecologist
CLINICAL
MANIFESTATIONS-
•
Preceded
by symptoms of severe preeclampsia:
•
Severe
headache
•
Visual
disturbances
•
Epigastric/RUQ
pain
•
Nausea,
vomiting
•
Oliguria
•
Seizures
•
Seizure
chacacteristics
•
Tonic–clonic
convulsions
•
Usually
self-limiting (1–2 minutes)
•
It May
progress to coma
•
Seizure may recur
•
COMPLICATIONS-
•
Complications (Maternal)
•
Cerebral
hemorrhage
•
Pulmonary
edema
•
HELLP
syndrome
•
Renal
failure
•
Disseminated
Intravascular Coagulation (DIC)
•
Death
•
Complications (fetal/neonatal)
•
Intrauterine
Growth Restriction (IUGR)
•
Preterm
birth
•
Hypoxia/asphyxia
•
Stillbirth
•
Neonatal
death
CAUSES AND RISK
FACOTRS
Pre-eclampsia is the precursor of eclampsia so all risk
factors of preeclampsia are also risk factors for ecclampsia
DIAGNOSTIC
INVESTIGATIONS-
• Urine
examination for protein
• Blood pressures
assesment
• Complete blood
count
• Serum
electrolytes
• Liver function
test
• Serum Urea and
Creatinine
• Ultrasound
• Doppler
velocimetry
• Electro
Encephalo Graphy (EEG)
MANAGEMENT-
Immediate
Management-
•
Assessment
and maintenance of Airway, Breathing, Circulation (ABC)
•
Place
woman in left lateral position
•
Maintain
airway, suction if needed
•
Oxygen
administration
•
Control
seizures with Magnesium Sulphate
Magnesium
Sulphate Therapy
It is the Drug of choice for ecclampsia
•
Loading:
4 g IV slowly + 10 g IM (5 g each buttock)
•
Maintenance:
5 g IM every 4 hours
•
Monitor
for toxicity (respiratory depression, reflexes, urine output)
•
Ante
hypertensive drugs
Obstetric
management
•
Definitive
treatment = Delivery
•
Stabilize
mother first
•
Assess
gestational age, fetal condition
•
Induce
labor or perform cesarean section if required
If the woman
gives birth vaginally, syntometrine and ergometrine should be avoided to manage
the third stage of labour and oxytocin
used instead.
NURSING
MANAGEMENT-
•
Management
during seizures
•
Stay
with patient and call for help
•
Provide
Position in left lateral side
•
Loosen
all tight clothing
•
Maintain
airway, suction secretions
•
Protect
from injury (do not force objects into mouth)
•
Management
after seizures
•
Monitor
vital signs, fetal heart rate
•
Insert
IV line for fluids/medications
•
Administer
MgSO₄ & antihypertensives as prescribed
•
Monitor
urine output (≥30 ml/hr)
•
Document
events carefully
•
The baby
is likely to be initially cared for on the neonatal unit and the woman should
be taken to see her babyas soon as her condition permits.
•
Breastfeeding
is to be encouraged and psychological support given by themidwife/nurse and
neonatal staff.
