Hypertension in pregnancy - Eclampsia signs and symptoms, management of impending eclampsia

Symptoms & signs of impending eclampsia:
Head ache- persistent occipital or frontal.
Visual disturbance.
Restlessness and agitation. Epigastric or right upper quadrant pain.
Nausea & vomiting.
Oliguria.
Laboratory evidence of DIC( dissiminated intravascular coagulation).

Eclampsia symptoms& signs:
Eclampsia seizures are almost always self- limiting.
The general condition of the women may not be greatly affected by infrequent seizures but repeated convulsions lead to rapid deterioration with cyanosis, tachycardia, deepening coma & death.

Management:
Impending eclampsia:
Aim is to prevent seizures.
Pt should be nursed in a quiet, darkened room, sedated if required & antihypertensive therapy initiated.
Anticonvulsant of choice for prevention of eclampsia is MgSO4 4gms IV in a 20% solution over 5mins followed by 5gms in each buttock.
Followed by 5gms every 4hrs in alternate buttocks.
Morphine, pethidine can be used but they are likely to cause maternal & fetal respiratory depression.


-Hypertension in pregnancy-classification
-Hypertension in pregnancy-gestational hypertension
-Preeclampsia
-Eclampsia, preeclamsia superimposed on chronic hypertension
-Chronic hypertension
-Hypertension in pregnancy-etiology and pathogenesis
-Pathology
-Mild hypertension in pregnancy-prevention and management
-Severe hypertension in pregnancy-management
-Severe preeclampsia in pregnancy-management
-Complications of hypertension
-Antihypertensive therapy- centrally acting drugs
-Antihypertensive therapy-beta blockers, calcium channel blockers
-Antihypertensive therapy-alpha blockers, vasodilator, diuretics, ACE inhibitors
-Acute severe hypertension - treatment
-Eclampsia - signs and symptoms
-Eclampsia - management