Difference between revisions of "Eclampsia"

 
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#Redirect[[Preeclampsia, Eclampsia, and HELLP]]
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=== Background ===
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*Preeclampsia and eclampsia are diagnosed after 20wks gestation and <4wk post-partum
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**May occur sooner w/ gestational trophoblastic disease
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*Suspect in any pregnant pt who is >20wk or <4wk postpartum who develops seizures
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===Treatment===
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#Delivery
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#Seizure Tx
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##Magnesium: Load 4-6g IV over 15min followed by 2-3gm/hr
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###Can give up to 10gm IM
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###Observe for loss of reflexes, respiratory depression
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###Must adjust dose in pts w/ renal failure
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##If seizures recur:
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###Consider other anticonvulsant drugs
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###Consider alternative diagnosis
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#BP Control
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##Lower to Sys 130-150, dia 80-100
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###Labetalol
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####Option 1: Initial 20mg; then doses of 20-80mg q10min to total of 300mg
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####Option 2: Initial 20mg; then IV infusion of 1-2mg/min
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###Hydralazine
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####5mg IV over 1-2min; repeat bolus of 5-10mg q20min PRN to total of 30mg
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===Disposition===
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*Emergent OB/GYN consultation
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==See Also==
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*[[Post-Partum Emergencies]]
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*[[Eclampsia]]
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==Source==
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*Tintinalli
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*EBM, Volume 12, Number 8, Aug 2010. Postpartum Emergencies
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*Uptodate
  
 
[[Category:OB/GYN]]
 
[[Category:OB/GYN]]

Revision as of 00:59, 17 January 2012

Background

  • Preeclampsia and eclampsia are diagnosed after 20wks gestation and <4wk post-partum
    • May occur sooner w/ gestational trophoblastic disease
  • Suspect in any pregnant pt who is >20wk or <4wk postpartum who develops seizures

Treatment

  1. Delivery
  2. Seizure Tx
    1. Magnesium: Load 4-6g IV over 15min followed by 2-3gm/hr
      1. Can give up to 10gm IM
      2. Observe for loss of reflexes, respiratory depression
      3. Must adjust dose in pts w/ renal failure
    2. If seizures recur:
      1. Consider other anticonvulsant drugs
      2. Consider alternative diagnosis
  3. BP Control
    1. Lower to Sys 130-150, dia 80-100
      1. Labetalol
        1. Option 1: Initial 20mg; then doses of 20-80mg q10min to total of 300mg
        2. Option 2: Initial 20mg; then IV infusion of 1-2mg/min
      2. Hydralazine
        1. 5mg IV over 1-2min; repeat bolus of 5-10mg q20min PRN to total of 30mg

Disposition

  • Emergent OB/GYN consultation

See Also

Source

  • Tintinalli
  • EBM, Volume 12, Number 8, Aug 2010. Postpartum Emergencies
  • Uptodate