Eclampsia

 Def.
 Seizure activity or coma unrelated to
other cerebral conditions in an
obstetrical patient with pre-eclampsia
Clinical features
 Signs – Tonic-clonic seizure activity
 Symptoms – are those of severe
pre-eclampsia.
 However in some patients there
may be no
 Oedema
 Protienuria
 Reflexes may be normal.
Timing
 25% before labour
 50% intrapartum
 25% post-partum
 DD
 Cerebral tumours
 Cerebral venous thrombosis
 Drug overdoses
 Epilepsy
 Intracranial haemorrhage
 Head trauma
 CVA
 Electrolyte imbalance.
 Meningitis
 Metabolic Disorders e.g. DM
Investigations
 As for pre-eclampsia
 CT scan to exclude venous
thrombosis, intracrfanial
heamorrhage, CNS leisions
 CT safety
 MRI
Treatment
 Eclamptic seizures are life
threatening emergencies
 Team work
 Continuous intensive monitoring
 Minimal noise
Initial management
 Clear airway
 Adequate O2
 Place in (L) lateral position
 Guardrails should be up on bed
 Suction PRN
 IV – Access + Lab inv.
Hypertension control
 Bp should be recorded every 10
minutes
 Bp should be controlled to DBp 90-100
mmHg
 Monitoring
 Asses neurologic status
 Urine output
 RR
 Fetal status
 Pass indwelling foley catheter and retain
 Pulmonary artery pressure monitoring.
Reassessment
 Re-assess medical condition
 Induction of labour once patient is
stable.