Diagnosis Criteria Gestational Systolic BP ≥ 140 or diastolic BP ≥ 90 mm Hg for first time Hypertension during pregnancy No proteinuria BP returns to normal before 12 weeks postpartum Final diagnosis made only postpartum May have other signs or symptoms of preeclampsia, for example, epigastric discomfort or thrombocytopenia Preeclampsia Minimum criteria: BP≥ 140/90 mm Hg after 20 weeks' gestation Proteinuria ≥ 300 mg/24 hours or ≥ 1+ dipstick Increased certainty of preeclampsia: BP ≥ 160/110 mm Hg Proteinuria 2.0 g/24 hours or ≥ 2+ dipstick Serum creatinine >1.2 mg/dL unless known to be previously elevated Platelets < 100,000/ᶣL Microangiopathic hemolytic—increased LDH Elevated serum transaminase levels—ALT or AST Persistent headache or other cerebral or visual disturbance Persistent epigastric pain Eclampsy Seizures
(Cunningham, et al., 2010. Williams Obstetrics. 23rd Edition)
EKLAMPSIA TANDA-TANDA IMPENDING: 1. SAKIT KEPALA 2. NYERI ULU HATI 3. PANDANGAN KABUR MANAJEMEN PRA-RUJUKAN (NPM)
NIFEDIPIN PASANG INFUS MgSO4
& KATETER NPM • DOSIS: 3 x 10 MG • CARA: PER ORAL KATETER IV NO.18 KATETER URIN NO.14 ATAU 16 BLOOD SET MgSO4 ADALAH ANTI-KEJANG Syarat : Frek. Nafas > 16 BUKAN ANTI-HIPERTENSI kali/menit, Ref.patella (+), Urin > 30 ml/jam REJIMEN MgSO4 40% : 8 mg (20cc) dlm 500 RL • 250cc (4 mg) dosis inisial habis dlm 15 menit • 250 cc habis dlm 4 jam : dosis mentenance (1mg/jam) • 2 mg (5cc) i.v ekstra setiap terjadi kejang Antidotum : Ca Gukonas 1gr i.v bolus pelan TERIMA KASIH