Pre-eclampsia

Question 1

What are the signs of Magnesium sulphate toxicity?

Answer 1

Decreased respiratory effort
Decreased deep tendon reflexes
Decreased urine output

Question 2

How do you manage magnesium sulphate toxicity?

Answer 2

Stop drug (don’t administer next dose)
Give 10ml calcium glauconite IVI
Ventilator support as needed

Question 3

Define pre-eclampsia

Answer 3

Hypertension (>140/90 on two occasions taken 4 hours apart) after 20 weeks gestation with proteinurea or other systemic dysfunction

Question 4

How do you follow up patients postpartum who had pre-eclampsia?

Answer 4

Follow up in 6 and 12 months = BP and glucose measurements
1 year postpartum with early onset pre-eclampsia (<34weeks) = echocardiogram

Question 5

What are pre-eclampsia patients at risk for?

Answer 5

Diabetes mellitus T2
Cardiac diastolic function
Chronic hypertension

Question 6

What is the dose of magnesium sulphate?

Answer 6

Load: 4g in 200ml 0,9% NaCl given over 20-30mins PLUS 5g IMI in each buttock
Maintenance: 5g IMI in alternating buttocks every 4 hours for 24 hours

Question 7

What signs/sx do you monitor when treating with Magnesium Sulphate?

Answer 7

Deep tendon reflexes
Urine output
Respiratory rate

Question 8

How do you treat a patient who repeat seizures on magnesium sulphate?

Answer 8

Reload 2g MgSO4 in 200ml NaCl stat

Question 9

What is HELLP syndrome?

Answer 9

A patient has
1)haemolysis (abnormal peripheral smear and LDH >600)
2) elevated liver enzymes (AST or ALT >70)
3) low platelets (<100x10^9)

Question 10

What is eclampsia?

Answer 10

Seizures in the presence of Pre-eclampsia or HELLP syndrome