Eclampsia

Revision as of 00:59, 17 January 2012 by Rossdonaldson1 (talk | contribs)

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