Eclampsia

Question 1

What is eclampsia?

Answer 1

New-onset generalized tonic-clonic seizures in a woman with preeclampsia

Question 2

What is the underlying condition that precedes eclampsia?

Answer 2

Preeclampsia

Question 3

What symptoms may precede eclampsia?

Answer 3

Severe headache, visual changes, RUQ pain, nausea/vomiting

Question 4

What kind of seizures are seen in eclampsia?

Answer 4

Generalized tonic-clonic seizures

Question 5

Is imaging required to diagnose eclampsia?

Answer 5

No

Question 6

What is the first step in managing a patient with eclampsia?

Answer 6

Stabilize airway, breathing, and circulation

Question 7

What medication is used for seizure control in eclampsia?

Answer 7

Magnesium sulfate

Question 8

What is the purpose of magnesium sulfate in eclampsia?

Answer 8

Prevent and treat seizures

Question 9

How is magnesium sulfate administered in eclampsia?

Answer 9

IV loading dose followed by continuous infusion

Question 10

What are signs of magnesium toxicity?

Answer 10

Hyporeflexia, respiratory depression

Question 11

What is the antidote for magnesium toxicity?

Answer 11

Calcium gluconate

Question 12

What antihypertensives are used in eclampsia?

Answer 12

IV labetalol or hydralazine

Question 13

When are antihypertensives indicated in eclampsia?

Answer 13

If BP ≥160/110 mmHg

Question 14

What is the definitive treatment for eclampsia?

Answer 14

Delivery

Question 15

Should delivery be delayed to complete magnesium or steroids in eclampsia?

Answer 15

No, proceed after stabilization

Question 16

Is cesarean section mandatory in eclampsia?

Answer 16

No, only if obstetrically indicated

Question 17

What labs are typically abnormal in eclampsia?

Answer 17

↓ platelets, ↑ AST/ALT, ↑ creatinine

Question 18

What lab confirms proteinuria in eclampsia?

Answer 18

Urine protein/creatinine ratio ≥0.3 or ≥300 mg/24 hr

Question 19

What fetal complications are associated with eclampsia?

Answer 19

Hypoxia, preterm birth, stillbirth

Question 20

What maternal complications can result from eclampsia?

Answer 20

Stroke, aspiration, DIC, renal failure, pulmonary edema

Question 21

How long should magnesium sulfate be continued postpartum?

Answer 21

24 hours postpartum

Question 22

Can eclampsia occur postpartum?

Answer 22

Yes

Question 23

What should be done if seizures persist despite magnesium sulfate?

Answer 23

Additional magnesium dose or benzodiazepines

Question 24

What is the goal BP range in eclampsia management?

Answer 24

Lower BP to prevent stroke; typically <160/<110 mmHg

Question 25

When should magnesium sulfate be withheld?

Answer 25

If signs of toxicity: hyporeflexia, bradypnea, decreased urine output

Question 26

What differentiates eclampsia from preeclampsia with severe features?

Answer 26

Presence of seizures

Question 27

What should you monitor during magnesium sulfate therapy?

Answer 27

Deep tendon reflexes, respiratory rate, urine output

Question 28

Can proteinuria be absent in eclampsia?

Answer 28

Yes, if other severe features are present

Question 29

What is the most common cause of death in eclampsia?

Answer 29

Intracranial hemorrhage

Question 30

What distinguishes eclampsia seizures from epilepsy?

Answer 30

Occur in context of preeclampsia, often with warning signs and resolve postpartum