Lectures of eclampsia

2021-03-21 12:00 AM

After a general seizure, the patient breathed in a long breath, and the hypoxia temporarily ceased. But then there was agitation again, her expression crumpled

Define

A complication of hypertensive disorders during pregnancy that is clinically manifested by continuous convulsions that end in a coma. Eclampsia can occur before, during, and after childbirth.

Clinical symptoms of eclampsia

Typical eclampsia needs to go through four stages: infiltration, jerking, stretching, and coma.

Infection phase (about 30 seconds to 1 minute)

The main symptoms as follows: major irritations of the face and neck, not spreading to the hands, wrinkled facial features, eyes burning.

Rigid jerking phase (approx. 30 seconds)

The body muscles twitched stiffly, and the body flexed and stiffened. The spasmodic muscles of the larynx make the patient screech, the asphyxiation causes the patient to turn purple, the hands are jerking like a drummer, the tongue sticks out and gets in and out so it is easy to bite the tongue, the bridge moves back and forth.

Interval period

After a general seizure, the patient breathed in a long breath, and the hypoxia temporarily ceased. But then there was the agitation, the face was crumpled again, the tongue stuck out and went into a coma.

Coma stage

Depending on the condition of the disease severe or mild, the appearance of a coma or deep coma. During a coma, the patient loses consciousness, dilated pupils, urinates incontinence, and the patient may die in a prolonged coma. One characteristic is that during a coma if the illness is severe, it is possible to develop seizures.

Subclinical symptoms

Elevated serum uric acid.

Serum urea and serum ureaatinin increased, platelet count decreased in most cases, fundoscopy showed signs of Gunn, edema or retinal haemorrhage.

Diagnose

Implementing the quadrants

Based on the compulsory eclampsia must go through the four stages described above.

Differential diagnosis

Serum calcium lowering attack (T├ętani attack).

Seizures.

Diabetic coma.

Lethargy due to liver, high serum urea.

Complications of eclampsia

Complications for the mother

Biting of the tongue, acute pulmonary oedema, heart failure, liver failure, kidney failure, brain haemorrhage, death (mostly due to acute pulmonary oedema, renal failure or cerebral haemorrhage)

Complications for children

Stillbirth in utero, underdeveloped fetus, postpartum death, premature birth (due to high intervention rate).

Treatment attitude

Medical and nursing treatment

In addition to points like pre-taxation, need attention and extra work:

Close your mouth to prevent biting your tongue.

Smoking phlegm.

Breathe oxygen.

Intravenous nourishment.

Medicine

Magnesium sulphate 4-6 g intravenously slowly for 10 to 15 minutes. Then, inject 1g into the muscle every 1 hour until eclampsia is under control.

Pay attention to the side effects of magnesium sulfate.

Valium 10 mg. Every 1-2 hours, 1 ampoule of 10mg is injected intravenously until the seizure is controlled.

Antihypertensive drugs:

Hydralazine (Neprenol) 5 mg by slow intravenous injection.

Aldomet.

Adalat 10 mg sublingual if necessary.

Diuretic: Lasix 20 mg: 1-2 ampoules intravenously. If urine is not present, increase dose until urine is present. Need to add Kaliorite

Antibiotics: Beta lactamin group: Ampicillin, Augmentin.

Obstetric treatment

Common for both pre-eclampsia and eclampsia, if respond to treatment, continue developing pregnancy, if not respond to treatment, suspend pregnancy. If the fetus is alive, it is best to have a cesarean section.