Pre-eclampsia/Eclampsia. Pre-eclampsia: hypertension >140/90, proteinuria >0.3g/L Eclampsia:...
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Transcript of Pre-eclampsia/Eclampsia. Pre-eclampsia: hypertension >140/90, proteinuria >0.3g/L Eclampsia:...
![Page 1: Pre-eclampsia/Eclampsia. Pre-eclampsia: hypertension >140/90, proteinuria >0.3g/L Eclampsia: seizures Incidence: – Pre-eclampsia: 2-10% of all pregnancies.](https://reader036.fdocuments.us/reader036/viewer/2022082407/56649ec65503460f94bd13c1/html5/thumbnails/1.jpg)
Pre-eclampsia/Eclampsia
![Page 2: Pre-eclampsia/Eclampsia. Pre-eclampsia: hypertension >140/90, proteinuria >0.3g/L Eclampsia: seizures Incidence: – Pre-eclampsia: 2-10% of all pregnancies.](https://reader036.fdocuments.us/reader036/viewer/2022082407/56649ec65503460f94bd13c1/html5/thumbnails/2.jpg)
• Pre-eclampsia: hypertension >140/90, proteinuria >0.3g/L
• Eclampsia: seizures• Incidence:– Pre-eclampsia: 2-10% of all pregnancies– Eclampsia: 2-6 in 10000 deliveries
• 1.8% maternal mortality
![Page 3: Pre-eclampsia/Eclampsia. Pre-eclampsia: hypertension >140/90, proteinuria >0.3g/L Eclampsia: seizures Incidence: – Pre-eclampsia: 2-10% of all pregnancies.](https://reader036.fdocuments.us/reader036/viewer/2022082407/56649ec65503460f94bd13c1/html5/thumbnails/3.jpg)
History & Examination• Symptoms– Headache– Visual disturbance– Epigastric pain– Fetal movements
• Signs– BP, proteinuria– Hepatic tenderness– Clonus, hyperreflexia– Papilloedema
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Antihypertensives
• Labetolol– Orally– Intravenous
• Nifedipine– Orally
• Hydralazine– intravenous
• Methyldopa – slow acting
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Anticonvulsants
• Magnesium Sulphate– 4g IV push– Maintenance dose 1-2g/hour
• Monitor for signs of toxicity– Loss of deep tendon reflexes– Respiratory depression– Coma– Cardiac arrest
• Calcium gluconate
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Scenario
• A patient at 30 weeks gestation on the ward was found fitting by the staff midwives
• She is hypertensive 160/120, with +4 proteinuria
• You are called to attend
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• ABCs!!!• Help – midwives, senior obstetrician,
anaesthetist• IV access• Lab investigations– FBC, U&Es, LFTs, coag
• Stabilise patient before fetus
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• Mg SO4• Antihypertensives• Fluid restriction – no more than 80ml/hour• HDU monitoring• Delivery when stabilised
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Summary
• ABC’s• Stabilise patient• Antihypertensives/anticonvulsants• Delivery