| ID | 336 |
|---|---|
| Name | PRE-ECLAMPSIA |
| Cause | Preeclampsia in a previous pregnancy. Being pregnant with more than one baby. Chronic high blood pressure (hypertension) Type 1 or type 2 diabetes before pregnancy. Kidney disease. Autoimmune disorders. Use of in vitro fertilization. |
| Signs Symptoms | High blood pressure with or without protein in the urine. ... Changes in vision, like blurriness, flashing lights, seeing spots or being sensitive to light. Headache that doesn't go away. Nausea (feeling sick to your stomach), vomiting or dizziness. |
| Diagnosis | Diagnosis: Diagnosis is made from the following positive findings - 1. Blood pressure is above 140/90 mm Hg. 2. Urine exam.- albumin/protein present. 3. Presence of oedema in the dependent parts. |
| Investigations | Blood pressure is regularly checked for signs of high blood pressure and a urine sample is tested to see if it contains protein. |
| Management | Management: 1. Hospitalization: When there is rise of B.P., proteinurea, and excessive weight gain. 2. Bed rest: The patient is kept in a dark quite room. Diazepam 10-20mg. at night. 3. Routine observations: -Weight measurement daily; B.P. recording; fluid intake and output chart; urine examination daily (for albumin); fundoscopic examination; frequent assessment of foetus. 4. Diet: Dietary salt restricted; fluid restriction and diuretics (frusemide) if required. 5. Hypotensive drugs: Reserpine 0.1 mg. Or, Hydralazine sulphate l0mg t.d.s. Or, Methyldopa 250mg t.d.s. 6. Monitoring of the pregnancy: a. Blood pressure and urine for protein- 2-3 times daily. b. Sacral oedema. c. Intake output chart. d. Regular palpation of foetal hight. e. Foetal heart sound and kick count. f. Urinary oestradiol and biochemical test. These supportive therapy to be continued upto 38 weeks of pregnancy. 7. If the patient improved with the above treatment, he should be sent to the home with following advices - a. Bed rest more than 2 hour at noon and (8-10) hours at night, b. Restrict normal daily household activity, c. Night sedatoin by diazepam. d. High protein, reduce fat and carbohydrate diet, e. Salt restricted diet. 8. If the condition deterioriates- Termination of pregnancy to be done by - a. Sweeping and Oxytocin drip. Or, b. ARM + Oxytocin. If fails -Cesarean section. Indications for cesarean section: 1. PET worsen after rupture of membrane. 2. Foetal distress at 1st stage. 3. When vaginal delivery contraindicated. 4. When labour not start within 24 hours of induction. |
| Introduction | Pre-eclampsia is a syndrome complex charac-terised by development of hypertension to the extent of 140/90mm of Hg or more with oedema or proteinuria or both induced by pregnancy after the 20th week. |
| History | |
| Etiology | Etiology: The exact etiology of pre-eclampsia is not known, but there is an increased incidence of pre-eclampsia in association with multiple pregnancy, with hydramnios, with diabetes, with severe rhesus incompatibility and in cases of vesicular mole. |
| Clinical Features | see under sign and symptoms |
| Preventions | Use of low-dose aspirin |
| Treatment | Treatment of severe preeclampsia Antihypertensive drugs to lower blood pressure Anticonvulsant medication, such as magnesium sulfate, to prevent seizures Corticosteroids to promote development of your baby's lungs before delivery Delivery After delivery You need to be closely monitored for high blood pressure and other signs of preeclampsia after delivery. if patients have signs of postpartum preeclampsia, such as severe headaches, vision changes, severe belly pain, nausea and vomiting. |
| Complications | HELLP syndrome. Postpartum eclampsia (seizures). This can cause permanent damage to our brain, liver and kidneys. ... Pulmonary edema. This is when fluid fills the lungs. Stroke. Thromboembolism. |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
© Pakistan Drug Directory. All Rights Reserved.
Designed By: Pakistan Drug Directory Team