Secretariats General
Definition of EPH-Gestosis
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a) Gestosis

b) Signs and Symptoms

c) Eclampsia Imminens (EI)

d) Eclampsia Convulsiva (EC)
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a) Symptomatic

b) Pathogenetic
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b) Hospitalized Patient

c) Eclampsia, Imm. & Convuls.
Medicaments not recommend.
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OG
C. ECLAMPSIA IMMINENS (ΕΙ)
ECLAMPSIA CONVULSIV Α (EC)
 
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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