Medical and Surgical Complications in Pregnancy
36 week pregnant female presents with high blood pressure, 180/110 mmhg with blurred vision and headache management includes:
|A||Admit & give anti hypertensives, mgso4 and terminate|
|B||Admit & give anti hypertensives, mgso4 and observation|
|C||Only admit and watch|
|D||Give anti hypertensives and send home|
Admit & give anti hypertensives, mgso4 and terminate
a. The patient is a case of severe preeclampsia, with impending eclampsia.
b. The dangerous symptoms that indicate impending eclampsia in case of preeclampsia are:
iii. Epigastric pain
iv. Nausea, vomiting
v. Blurring of vision
c. Whenever the above symptoms develop in a case of severe preeclampsia the patient is at a risk of eclampsia; the patient should be given anticonvulsant (MgSO4) and antihypertensive medication, and the pregnancy should be terminated (as delivery is the definitive treatment) irrespective of theweeks of gestation.
d. Magnesium sulfate is the drug of choice for eclampsia and also for impending eclampsia.
e. Prophylactic magnesium sulfate decreases the risk of convulsion, abruption, and maternal mortality in this scenario.
f. The indications for termination of pregnancy (irrespective of the weeks of gestation) in a case of preeclampsia are:
i. Severe preeclampsia, with impending eclampsia
ii. Eclampsia (give MgSO4 first, followed by induction of labor)
iii. HELLP syndrome