eclampsia

Question 1

what is eclampsia

Answer 1

when severe pre-eclampsia is complicated with generalised convulsions

Question 2

what is pre-eclampsia

Answer 2

hypertensive disorder of pregnancy

with multi-organ involvement

Question 3

what characterises pre-eclampsia

Answer 3

new onset HT
associated proteinuria

after 20wks gestation

Question 4

when can eclampsia occur

Answer 4

antepartum - 50%
intrapartum - 30%
post-partum - 20%

Question 5

what causes eclampsia

Answer 5

cerebral oedema +/- cerebral haemorrhage

Question 6

clinical features of eclampsia

Answer 6

headahe
BP >160 systolic
hyperreflexia
visual changes

Question 7

what type of seizures are seen in eclampsia

Answer 7

tonic-clonic

Question 8

differentials for eclampsia

Answer 8

epilepsy
encephalitis
metabolic disorders

Question 9

how severe is eclampsia

Answer 9

obstetric emergency

manage w/ ABC approach

Question 10

bloods to take in eclampsia

Answer 10

LFTs
U+Es
coagulation
FBC

Question 11

management of eclampsia

Answer 11

IV magnesium sulphate (continue for 24hrs post delivery)
antihypertensives - labetolol, hydralazine
delivery of child

Question 12

how does magnesium sulphate work

Answer 12

causes cerebral dilatation

competitively blocks Ca at synaptic nerve endings

Question 13

what should be monitored whilst on magnesium sulphate

Answer 13

RR
reflexes
UO

Question 14

what is the antidote to magnesium sulphate

Answer 14

calcium gluconate

should be given if toxicity to magesium sulphate develops

Question 15

what is the only cure for eclampsia

Answer 15

delivery of child

Question 16

complications of eclampsia

Answer 16

HELLP syndrome 
DIC
acute respiratory distress
pulmonary oedema
aspiration
fetal hypoxia 
increased maternal mortality

Question 17

how to decrease risk of pre-eclampsia in subsequent pregnancies

Answer 17

low dose aspirin from 12wks