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C.
ECLAMPSIA
IMMINENS (ΕΙ)
ECLAMPSIA CONVULSIV Α (EC) |
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Both conditions require immediat hospitalisation ίπ a well
equipped, with a special care unit, sufficiently staffed, with a competent and
experienced staff. If ever possible
1.
GENERAL PREPARATIONS.
1.Patient is being announced.
a.
Protected, isolated room (cave : noise,
light)
b.
Wedge ready to protect the tongue
c.
Anesthesia ready. (imminent convulsions, emergency
situation, cesarean section, forceps delivery)
d.
Neonatal care (reanimation, prematurity asphyxia)
e.
Medicaments
2.
Patient has arrived.
a.
frequent check-ups by obstetrician, every 30 Minutes. Assess rapidly changing
situation
b.
Permanent attendance by trained midwife
c.
Exact protocoll of the patients conditions, the check-ups, medicaments.
Mark the exact time
2. SPECIAL
CARE
3.
a.
Isolate patient
b.
Cut out noise
c.
Cut out light
4.
Blood pressure readings
a.
immediately upon admission
b.
every 15 to 30 Minutes
5. Medication
a rapid and complete sedation (e.g. Diazepam ί.ν.)
Only after these preparations
6. Get blood
samples for
Blood grouping
Hemoglobin
Hematokrit
Proteins and fractions
Urate
RBC
WBC
etc
7. Test two units
of blood
8. Infusion ίπ
place. Νο NaCI, slow drip, keep access open
9. Urinary
excretion
Folley catheder
input / output
content of υrin :
Proteins, quantitatve
Sediment
Specific weight
etc.
10. Mg sulfate
Mg gluconate
11. Treat with
hypotensive drugs
to prevent danger to the mother (imminent CVΑ)
to prevent eclamptic seizures
12.
Start diuresis,
e.g. Mannitol 5O cc 20% ίπ ί.ν. drip
diuretics if
required, only by experinced obstetrician
3. Assess the need for active
termination of pregnancy ίπ imminent Eclampsia
13.
Survival of baby possible : Cesarean Section
14.
Survival of baby unlikely
or dead baby ; Keep risk for Mother
low. Expectant procedure possible
15.
Ιπ Eclampsia Convulsiva ( EC ) wait if possible for 24h before Cesarean Section.
The treatment of ΕΙ and EC requires much experience and team work with other
specialists. But ALWA YS ΤΗΕ OBSTETRICIAN IS ΙΝ CHARGE |
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