Management of Eclampsia

Question 1

First step of management

Answer 1

1. Airway
2. Breathing
3. Circulation

Question 2

What is the drug of choice for seizure control?

Answer 2

Magnesium sulphate

Question 3

What does magnesium sulphate do?

Answer 3

1. Controls fits

2. Prevents seizures

Question 4

How should magnesium sulphate be given?

Answer 4

1. Loading dose of 4g given over 5 - 10 minutes

2. Infusion of 1 g per hour over 24 hours

Question 5

Management of repeated seizures

Answer 5

Diazepam

Question 6

How to check for magnesium toxicity?

Answer 6

1. Check reflexes every hour ( knee reflexes)

Question 7

Signs of magnesium toxicity?

Answer 7

1. Confusion
2. Loss of reflexes
3. Respiratory depression
4. Hypotension

Question 8

Treatment for magnesium toxicity?

Answer 8

Calcium gluconate over 10 minutes

Question 9

What monitoring is done and how often?

Answer 9

1. Pulse
2. BP
3. Respiratory rates
4. O2 sats
   Done every 15 minutes

Question 10

If found to be hypertensive

Answer 10

1. Oral nifedipine

2. IV labetalol ( avoid in asthmatics )

Question 11

When to stop Mg infusion

Answer 11

1. Oliguria

2. Raised creatinine

Question 12

Why should patient be fluid restricted?

Answer 12

Risk of pulmonary oedema

Question 13

How to delivery

Answer 13

1. Fetal CTG continously monitored
2. Deliver fetus once mom is stable
3. Vaginal delivery is not contraindicated if cervix is favourable

Question 14

How should 3rd stage of labour be managed

Answer 14

1. Oxytocin rather than Syntometrine or ergometrine because of increase in blood pressure