General measures:
-Patient who is convulsing or just had a convulsion, the first priority is to avoid maternal injury & immediate attention to the airways.
- Pt should be nursed in left lateral position.
- Secretions or vomitus to be suctioned.
-A padded tongue blade or airway is inserted b/n the teeth to avoid tongue bite & maintain airway.
- Oxygen should be given by mask at 8 to 10 litres /min to correct maternal & fetal hypoxia.
-IV access is secured and treatment commenced to prevent seizures.
- Once the patient is little stabilised and not restless, she should be catheterized with an indwelling catheter and vaginal examination performed to assess the cervical status.
Control of seizures:
1.MgSO4 : Drug of choice for the control of seizures.
Loading dose of 4g IV, 20ml of 20% solution over 15 to 20 min followed by 5g in each buttock.
This is followed by 5gms IM in alternate buttock every 4hrs.
Magnesium toxicity can lead to respiratory paralysis, cardiac conduction defects & cardiac arrest.
The first sign of impending toxicity is loss of patellar reflex, therefore repeat doses should be given only if patellar reflex is present, RR(respiratory rate) > 12/min & urine output>100ml in previous 4hrs.
2.Diazepam: Highly effective in arresting immediate convulsions. IV bolus 10mgs to prevent recurrence of convulsions.
An IV infusion of 80mgs in 1litre of 5% dextrose for 24 hrs.
Profound neonatal depression, floppy neonates & intractable hypothermia are side effects.
3.Phenytoin: IV loading dose 15 to 18 mgs/kg body wt followed by 100mgs iv every 8hrs to prevent recurrence.
There are no significant maternal or fetal side effects.
-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
-Patient who is convulsing or just had a convulsion, the first priority is to avoid maternal injury & immediate attention to the airways.
- Pt should be nursed in left lateral position.
- Secretions or vomitus to be suctioned.
-A padded tongue blade or airway is inserted b/n the teeth to avoid tongue bite & maintain airway.
- Oxygen should be given by mask at 8 to 10 litres /min to correct maternal & fetal hypoxia.
-IV access is secured and treatment commenced to prevent seizures.
- Once the patient is little stabilised and not restless, she should be catheterized with an indwelling catheter and vaginal examination performed to assess the cervical status.
Control of seizures:
1.MgSO4 : Drug of choice for the control of seizures.
Loading dose of 4g IV, 20ml of 20% solution over 15 to 20 min followed by 5g in each buttock.
This is followed by 5gms IM in alternate buttock every 4hrs.
Magnesium toxicity can lead to respiratory paralysis, cardiac conduction defects & cardiac arrest.
The first sign of impending toxicity is loss of patellar reflex, therefore repeat doses should be given only if patellar reflex is present, RR(respiratory rate) > 12/min & urine output>100ml in previous 4hrs.
2.Diazepam: Highly effective in arresting immediate convulsions. IV bolus 10mgs to prevent recurrence of convulsions.
An IV infusion of 80mgs in 1litre of 5% dextrose for 24 hrs.
Profound neonatal depression, floppy neonates & intractable hypothermia are side effects.
3.Phenytoin: IV loading dose 15 to 18 mgs/kg body wt followed by 100mgs iv every 8hrs to prevent recurrence.
There are no significant maternal or fetal side effects.
-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
No comments:
Post a Comment