Seizures in pregnancy

Question 1

What is the definition of eclampsia?

Answer 1

development of seizures in association with pre-eclampsia

Question 2

What are the 3 conditions for the diagnosis of pre-eclampsia?

Answer 2

1. Condition seen after 20 weeks gestation
2. Pregnancy-induced hypertension
3. Proteinuria

Question 3

What is the drug used to prevent seizures in patients with severe pre-eclampsia and to treat seizures once they develop?

Answer 3

Magnesium sulphate

Question 4

What is the dosage of magnesium sulphate in eclampsia?

Answer 4

IV bolus of 4g over 5-10 minutes should be given, followed by infusion of 1g/hour

Question 5

What are 4 things which should be measured during treatment of eclampsia with magnesium sulphate?

Answer 5

1. urine output
2. reflexes
3. respiratory rate
4. oxygen saturations

Question 6

Why should respiratory rate and saturations be monitored during treatment with magnesiums sulphate?

Answer 6

respiratory depression can occur due to magnesium sulphate

Question 7

What is the first-line treatment for magnesium sulphate-induced respiratory depression?

Answer 7

calcium gluconate

Question 8

Until what point should treatment of eclampsia with MgSO4 continue?

Answer 8

for 24 hours after last seizure or 24 hours after delivery - 40% of seizures occur post-partum

Question 9

What is another important aspect of treating eclampsia in addition to magnesium sulphate and why?

Answer 9

fluid restriction to avoid potentially serious consequences of fluid-overload