Eclampsia

Question 1

What is eclampsia?

Answer 1

Eclampsia is when severe pre-eclampsia is complicated with convulsions

Question 2

What is pre-eclampsia?

Answer 2

Pre-eclampsia is as hypertensive disorder of pregnancy with multi-organ involvement, characterised by:

• New onset hypertension
• Proteinuria
• After 20 weeks gestation

Question 3

What is pre-eclampsia characterised by?

Answer 3

• New onset hypertension
• Proteinuria
• After 20 weeks gestation

Question 4

What is the aetiology of eclampsia?

Answer 4

• Due to cerebral oedema and/or cerebral haemorrhage

Question 5

When does most eclampsia occur (antepartum/intrapartum/postpartum)?

Answer 5

• 50% in antepartum, 30% in intrapartum and 20% in postpartum period

Question 6

What is the presentation of eclampsia?

Answer 6

• Headache
• BP > 160 systolic
• Hyperreflexia
• Visual changes
• Seizures
  
  • Tonic-clonic seizures

Question 7

What are some differentials for eclampsia?

Answer 7

• Epilepsy
• Encephalitis
• Metabolic disorders

Question 8

Describe the management of eclampsia?

Answer 8

• Obstetric emergency, using ABC approach
  
  • Secure airway, IV access and take bloods
• LFT, U and E, coagulation, FBC
• Magnesium sulphate
  
  • Administration – IV
  • Duration – continued for 24 hours after delivery
  • Effects – cerebral dilation, competitively blocks calcium at synaptic nerve endings
  • Monitor respiratory rate, reflexes and urine output
  • Antidote is calcium gluconate, given if toxicity develops
• Antihypertensive
  
  • Labetolol, hydralazine
• Delivery of child
• Prophylaxis of pre-eclampsia in future pregnancies
  
  • Low dose aspirin from 12 weeks

Question 9

What is used for prophylaxis in future pregnancies for eclampsia?

Answer 9

• Low dose aspirin from 12 weeks

Question 10

Describe for megnesium sulphate as a treatment of eclampsia: administration, duration, effects?

Answer 10

• Administration – IV
• Duration – continued for 24 hours after delivery
• Effects – cerebral dilation, competitively blocks calcium at synaptic nerve endings

Question 11

What needs monitored after administring magnesium sulphate for eclampsia?

Answer 11

• Monitor respiratory rate, reflexes and urine output

Question 12

What is the antidote for magnesium sulphate and when would it be given?

Answer 12

• Antidote is calcium gluconate, given if toxicity develops

Question 13

What are possible complications of eclampsia?

Answer 13

• HELLP syndrome
• DIC
• Acute respiratory distress
• Pulmonary oedema
• Aspiration
• Increased maternal mortality
• Foetal hypoxia