Impending eclampsia – This course is designed to understand the care of pregnant women and newborn: antenatal, intra-natal and postnatal; breast feeding, family planning, newborn care and ethical issues, The aim of the course is to acquire knowledge and develop competencies regarding midwifery, complicated labour and newborn care including family planning.
Impending eclampsia
Impending/Imminent Eclampsia:
It is a clinical entity whent the onset of the pre-eclamptic manifestations acute, occuring de novo or there is rapid deterioration in an established case of pre-eclampsia over a short period of time. There is a constant threat of either convulsion or coma
Management of Impending/Imminent Eclampsia:
A. Clinical fratures/diagnosis
When following signs present in a patient with pre-eclampsia it is called imminent eclampsia:
a) Headache, visual disturbances, spigastric pain, vomiting.
b) Rapidly developing oedema ve pulmonary oedema
c) Tenderness is the right upper quadront ofthe ablumen.
d) Recently developed hypertension with BP is more than 100/110 mm Hg with moderate te severe proteinuria or mpid rise in P
e)Hyperreflesia
f)Rapidly changing biochemical or hoomatological findings like elevated liver enzymes, low platelet count.
B. Treatment
Principles of treatment:
- To prevent fit
- To reduce blood pressure.
- To promote diuresia & 4. To detiver the fetus.
a) Immediate general management:
- Urgent hospitalization.
- Complete bed rest & patient should be kept in a quiet & eclampsia room under close supervision.
- If the patient condition does not permit to fed orally patient should be kept nothing by mouth & on IV fluid & electrolytes.
- Catheterization to monitor the urine output.
b) Immediate specific management:
- Prophylactic use of MgSO4 to prevent convulsion (Diazepam can also be used) should be started immediately. The dose schedule is same as eclampsia.
- To control blood pressure: The oral & hypertensive drugs used to redüce BP are mentioned in the “pre-eclampsia portion”
- For sedation: 75-100 mg Pethidine IIIVI or 5-10 mg I/M Diazepam is used for sedation.
- For diuresis: 20-40 mg I/V Frusemide used to increase the urine output & also to improve renal function.
- Careful monitoring: Monitoring of vital signs of mother, fetal movement & fetal heart rate.
c) Obstetric management:
- In case of term pregnancy: immediate termination of pregnancy is done either by bornog induction of labour or by C/S
- In case of pre-term pregnancy: Cortisone is given and then termination of pregnancy
Read More.