Eclampsia

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Background

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

Differential Diagnosis

Preeclampsia

Seizure

3rd Trimester/Postpartum Emergencies

Management

  1. Delivery
  2. Seizure treatment
  3. BP Control
    • Lower to Sys 130-150, dia 80-100
      • Labetalol
        • Option 1: Initial 20mg; then doses of 20-80mg q10min to total of 300mg
        • Option 2: Initial 20mg; then IV infusion of 1-2mg/min
      • Hydralazine
        • 5mg IV over 1-2min; repeat bolus of 5-10mg q20min PRN to total of 30mg
  4. Persistent seizure

Disposition

  • Admit, emergent OB/GYN consultation

See Also

References

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