Eclampsia

Eclampsia is a condition peculiar to pregnancy and postpartum periods, characterized by elevated BP associated with tonic-clonic convulsions .

In 50% of patients it can occur without prior elevation of BP.

Investigations

Full Blood Picture

Obstetric USS

Liver Function Test

Renal Function Test

Urine for protein

Malaria Rapid Diagnostic Test

Random Blood Glucose

Lumber Puncture

Treatment

Loading dose, Magnesium sulfate (IV) 4g of 20% (MgSO4) slowly over 5 minutes.

Maintenance dose, Magnesium sulfate 20% 1g per hour as an IV infusion OR 5g of undiluted 50% deep IM (Alternate buttocks) every four hours.

Continue with BP lowering protocols.

If convulsions recur within 15 minutes give;

magnesium sulfate 2g.

Features of Magnesium Sulphate toxicity

Respiratory depression

Reduced urine output

Loss of deep tendon reflexes

In case of magnesium sulphate toxicity

Stop magnesium sulphate administration

Calcium gluconate (IV) 1g slow bolus in 2 to 3 minutes

Definitive treatment

Immediate delivery regardless of gestational age.