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HYPERTENSIVE DISORDERS OF PREGNANCY Part 03

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Eclampsia

Grand mal seizures in a woman with preeclampsia

Management of Eclampsia

  1. airway, breathing, circulation seizure control and prevention
  2. do not attempt to shorten or abolish the initial convulsion
  3. prevent maternal injury and maintain adequate oxygenation
  4. minimize risk of aspiration, auscultate lungs after every seizure
  5. give adequate magnesium sulphate as soon as convulsion has ended
  6. correct maternal acidemia (obtain post-ictal blood gases)
  7. some use diazepam for seizure control

Chronic Hypertension

Features
  1. history of hypertension (> 140/90) before gestation
  2. detection of hypertension prior to 20 weeks gestation (unless there is a GTN)
  3. persistence of hypertension postpartum
  4. strong family history of hypertension
  5. most gravidas have essential hypertension, associated with an increased risk of preeclampsia or eclampsia, abruptio placenta, IUGR and IUD
Management


  1. methyldopa and/or labetalol
  2. no ACE inhibitors, diuretics, propranolol

Chronic Hypertension with Superimposed Preeclampsia/ Eclampsia 

  1. 2-7 fold increased likelihood of developing preeclampsia/ eclampsia if pre-existing maternal hypertension 
  2. tends to recur
  3. occurs early in pregnancy, tends to be severe, often with IUGR

Transient or Gestational Hypertension 
  1. hypertension alone that develops during the latter half of pregnancy or during the first 24 hours after delivery and disappears within 10 days following parturition
  2. monitor for signs of preeclampsia/eclampsia
HYPERTENSIVE DISORDERS OF PREGNANCY Part 03 HYPERTENSIVE DISORDERS OF PREGNANCY Part 03 Reviewed by Radiology Madeeasy on September 09, 2010 Rating: 5
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