Hypertensive conditions unique to pregnancy. Preeclampsia is marked by hypertension, protein in the urine, and hand and face edema, which develop late in pregnancy or soon after. Persistent hypertension compromises the fetus's blood supply and damages the mother's kidneys. Monitoring of blood pressure and weight gain may detect it before symptoms (headaches, visual disturbances, stomach pain) begin. Eclampsia follows in about 5percnt of cases, with convulsions that pose a serious threat to mother and child. It can usually be prevented by special diets, drugs, and limited activity or early delivery.
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Prevention of convulsion is usually done using magnesium sulfate with a loading of Magnesium sulfate 20% solution, 4g IV over 5 minutes, followed by 1g of magnesium sulfate an hour.
The blood pressure may be controlled by hydralazine 5mg IV slowly every 5 minutes until blood pressure is lowered . In less well resourced healthcare settings hydralazine 12.5 mg IM every 2 can be given as needed.
Delivery should take place as soon as the woman’s condition has stabilized. Delaying delivery to increase fetal maturity is unsafe for both the woman and the fetus, after delivery the woman's health will begin to improve. Delivery should occur regardless of the gestational age.
In severe pre-eclampsia, delivery should occur within 24 hours of the onset of symptoms. In eclampsia, delivery should occur within 12 hours of the onset of convulsions. If vaginal delivery is not anticipated within 12 hours (for eclampsia) or 24 hours (for severe pre-eclampsia), deliver by caesarean section.
Is eclampsia preventable? A case control review of consecutive cases from an urban underserved region.(Original Article)
May 01, 2004; Objectives: The purpose of this study was to determine whether eclampsia is potentially preventable. Methods: This was a...