Management of eclampsia

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1. Although magnesium sulphate is now recommended as the first line of treatment, the ABC management of a fitting patient may require initial control of convulsions with diazepam 2.5-5 mg, in order to secure the airway and maintain oxygenation whilst magnesium is being prepared. Magnesium therapy should be initiated without delay to prevent recurrence of fits (Brodie & Malinow 1999).Tracheal intubation, blood gas estimation and IPPV may be required at this stage.

2. Care should be taken to ensure that the diagnosis of eclampsia is correct. If a convulsion is not associated with hypertension and either oedema or proteinuria, or if the history and signs are atypical, then other causes must be eliminated. If an intracranial aneurysm is suspected, a CT scan should be performed.

3. For control of hypertension, see above.

4. The only ultimate control of eclampsia is termination of the pregnancy, either by rapid vaginal delivery or LSCS.

5. If an eclamptic patient remains unconscious 4—6 h postpartum, neurosurgical advice should be sought.A CT scan will distinguish cerebral oedema from intracranial haemorrhage. It has been suggested that the combination of diffuse white matter oedema and basal cisternal effacement is an indication for intracranial pressure monitoring (Richards et al 1986).A high intracranial pressure (n = 10—15 mmHg) may require specific treatment.

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Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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