logging in or signing up ECLAMPSIA Dr.SamiAbdalhameid Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 5596 Category: Education License: Some Rights Reserved Like it (2) Dislike it (0) Added: July 29, 2010 This Presentation is Public Favorites: 1 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript Slide 1: Eclampsia Slide 2: Pre- eclampsia Impending Eclampsia It is a disease of pregnancy characterized by BP 140/ 90 or more. After 20 week gestational age. In previous normotensive pt. Reading taken twice at interval 6 hours. Exclude other causes of 2.ry hypertension (ACDEPR) Slide 3: renal disease A C D E P R alchol coarctation of aorta drugs Endocrine disease PIH Slide 4: DBP110 or more Increase in SBP by 30 mmHg Increase in DBP by 15mmHg 2 read of MABP 105 or more OR increase by 20 But diagnosis can be by: This condition is associated with significant protienuria Slide 5: ??? Not related to the fetus or uterus Failure of placentation Abnormal lipid metabolism Decrease Ca++ in diet All pathogenesis due to vasospasm & endothelial dysfunction Aetiology: : Risk facctors: Primigravida age Past history Change the husband Condition in which placenta enlarge Pre-existing disease Low socioeconomic Risk factor decrease : Smokers Prolong exposure to paternal antigen Systemic effects : Systemic effects CVS Blood Renal system Liver CNS Incidence & Epidemiology : Incidence & Epidemiology Occur in 5-10% pregnancy Death about 2% in UK Death increase in Eclampsia which occur in intrapartum &post partum due to: -Relax of observation during these period -Increase in release of pathogenic factor Pre-eclampsia : Pre-eclampsia Symptoms: may be Asymptomatic Headache Visual disturbance Epigastric pain oedema Sign: may be High BP Fluid retension Brisk reflexs Fundel level less than date Impending eclampsiatransitional condition characterize by increase in : Impending eclampsiatransitional condition characterize by increase in Symptoms: Headache Visual disturbance Epigastric pain Nausea Restlessness Swelling Poor urine output signs: Agitation Hyperreflexia Facial &peripheral oedema Rt upper quadrant tendernes Slide 11: Eclampsia Clinical feature : Clinical feature it is grand mal convulsion which pass through stages of: Tonic contraction Clonic Coma Usually take about 60-90 seconds. Eden’s criteria of severity : Eden’s criteria of severity Coma take 6 hours or more SBP reach 200 mmHg Tm 39 or more Pulse rate 120/min RR 40/min 2 fits or more All this can end in maternal brain death Differential diagnosis : Differential diagnosis Epilepsy CVA SOL Drugs reaction Managments : Managments Aim of it : 1-maintain patent airways 2-prevents the fits 3-terminate the pregnancy Slide 16: Usually unnecessary to try to stop the initial convulsion which usually last about 60-90 seconds IV Diazepam slowly 5mg over 1 min 3. Roll the patient on his left side to avoid maternal injury Slide 17: 4. Apply Suction to the secretion from her mouth 5. Adequate Oxygen should be maintained by face mask & airways to prevent swallowing of tongue 6. Prevent further convulsions by MgSO4 by IV bolus of 4 – 6 g over 15 min. If convulsion recur further bolus of 2g. 7. Acidosis should be corrected if necessary by IV NaHCO3 8. SBP 170 mmHg or more, DBP 110 mmHg is risk factor for CVA so should be lowered by either Nifedipine 10 – 20 mg SL. Or Hydrallazine 5mg followed by infusion. Slide 18: After resuscitation 1.Insert canula size 10 2.Send blood to Lab for Hb, blood group, Platelet count, RFT, LFT, Uric acid concentration, coagulation study, RBS 3.Urine catheter (to urine output & protein) Slide 19: After the mother become stable 1.Assessment of state of fetus (U/S, Doppler CTG) 2.either : - Deliver the baby regardless of the gestational age intense monitoring maternal health in hope of improvement fetal outcome by increase gestational age. Slide 20: Post natal management It is attention to fluid balance , BP , Renal & Hepatic function & CNS 1.More aggressive control of BP 2.MgSO4 maintained for 48 hrs at 1g/hr iv 3.Subcutaneous heparin prophylaxis Slide 21: Maternal complications of eclampsia 2.permanent CNS damage 3.Intracranial haemorrhage 4.Renal failure 5.Death 1.During the fit tounge bitting head trauma bone # Aspiration Slide 22: Causes of Neonatal death 1.Prematurity 2.placenta infarction 3.IUGR 4.Abruptio placentae 5.Fetal hypoxia Slide 23: THE END You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.