Pre-eclampsia and Eclampsia

Posted by e-Medical PPT Wednesday, August 11, 2010
Eclampsia an acute and life-threatening complication of pregnancy, is characterized by the appearance of tonic-clonic seizures.Usually patients manifest signs of pregnancy-induced hypertension and proteinuria prior to the onset of eclamptic convulsion.Other cerebral signs may precede the convulsion such as nausea, vomiting, headaches, and cortical blindness.With the advancement of the pathophysiological process, patient may develop abdominal pain, liver failure, signs of the HELLP syndrome, pulmonary edema, and oliguria. Eclampsia, like preeclampsia, tends to occur more commonly in first pregnancies and young mothers where it is thought that novel exposure to paternal antigens is involved. Further, women with preexisting vascular diseases (hypertension, diabetes, and nephropathy) or thrombophilic diseases such as the antiphospholipid syndrome are at higher risk to develop preeclampsia and eclampsia.
Prevention of seizure convulsion is usually done using magnesium sulfate.Even with therapeutic serum Mg2+ concentrations, recurrent convulsions and seizures may occur—patients would receive additional MgSO4 but under close monitoring for respiratory, cardiac and neurological depression.Antihypertensive therapy at this stage in pregnancy may consist of hydralazine or labetalol.

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