ICU SAQs · Obstetric critical care
Eclampsia — the management
A CICM Second-Part SAQ on eclampsia — magnesium sulfate (Lu 4 g then 1 to 2 g/h; Omu 10 mL of 10 percent calcium gluconate), ACOG 30–60 min BP treatment, and planning for delivery.
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Prompt
A 32-year-old at 36 weeks gestation presents with a generalised seizure, BP 170/115, proteinuria 3+, platelets 85. Outline the management.
Question
A 32-year-old at 36 weeks gestation presents with a generalised seizure, BP 170/115, proteinuria 3+, platelets 85. Outline the management.[5][7]
References11ShowHide
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- [3]Adorno M, Maher-Griffiths C, Grush Abadie HR HELLP Syndrome Crit Care Nurs Clin North Am, 2022.PMID 36049847
- [5]The Eclampsia Trial Collaborative Group. Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial Lancet, 1995.PMID 7769899
- [6]Lu JF, Nightingale CH Magnesium sulfate in eclampsia and pre-eclampsia: pharmacokinetic principles Clin Pharmacokinet, 2000.PMID 10803454
- [7]Sibai BM Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count Obstet Gynecol, 2004.PMID 15121574
- [10]American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 767 Summary: Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period Obstet Gynecol, 2019.PMID 30681541
- [17]Lippert TH [Use of magnesium sulfate as an anticonvulsant in severe pregnancy toxemia and eclampsia]. Geburtshilfe Frauenheilkd, 1983.PMID 6557975
- [18]Omu AE, Al-Harmi J, Vedi HL, et al. Magnesium sulphate therapy in women with pre-eclampsia and eclampsia in Kuwait Med Princ Pract, 2008.PMID 18408392
- [19]Haram K, Svendsen E, Abildgaard U The HELLP syndrome: clinical issues and management. A Review BMC Pregnancy Childbirth, 2009.PMID 19245695
- [20]Vigil-De Gracia P, Lasso M, Ruiz E, et al. Severe hypertension in pregnancy: hydralazine or labetalol. A randomized clinical trial Eur J Obstet Gynecol Reprod Biol, 2006.PMID 16621226
- [21]Adebayo JA, Nwafor JI, Lawani LO, et al. Efficacy of nifedipine versus hydralazine in the management of severe hypertension in pregnancy: A randomised controlled trial Niger Postgrad Med J, 2020.PMID 33154284