Professional Documents
Culture Documents
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.