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1. Ammapalem (V), Konijerla (M), Khammam (Dist.) -
507305

2. DONE BY
NAME : SIRISHA KISTA
SUBJECT: PHARMACOTHERAPEUTICS-III
CLASS: PHARM D IV YEAR
YEAR: 2022-2023

3. TOPIC: CASE STUDY PRESENTATION ON A
“ECLAMPSIA”.

4. PATIENT DEMOGRAPHICS:
Patient name : XXXXX
 Age : 22 yrs
 Gender: Female
 Department :MATERNITY
 DOA : 25-09-2022
IP NO: 2918

5. SUBJECTIVE EVIDENCES:
A 22 year old female patient was admitted in
maternity ward with complaints of primi
with 9 months of pregnancy with Seizers
and High blood pressure.

6. Past medication history : Nil
 Past medical history : Nil
 Smoking : Nil
Alcoholic : Nil

7.  Patient is conscious and co-operative.
 On examination her BP was 150/90mmHg
 Pulse rate was 86bpm.
 Respiratory rate was 22bpm.
 The patient delivered with Female baby with weight of 3kgs.

8. Differential Leukocyte Count (DLC):
1. Neutrophils: 66%
2. Eosinophils: 04%
3. Basophils: 01%
4. Leukocytes: 30%
5. Monocytes: 08%
WBC count: 6300cells/cmm.
Platelet count: 1.8lakh/mm3
Clotting time: 4:30min
Bleeding time: 2:30min

9. Based on the subjective and objective
evaluations, the patient was diagnosed
with “PRIMI WITH ECLAMPSIA”.

10. ECLAMPSIA

11.  Eclampsia is a severe complication of preeclampsia. It’s a rare
but serious condition where high blood pressure results in
seizures during pregnancy.
 Seizures are periods of disturbed brain activity that can cause
episodes of staring, decreased alertness, and convulsions
(violent shaking).

12.  Problems with cells that line inside of certain blood vessels.
 Over production , under production or malfunction of protein
needed to grow new blood vessels in the placenta.
 Abnormal development of capillaries and certain types of
muscles with in the placenta.
 Increased overall sensitivity to hormones that regulate BP and
blood flow in different parts of body.

13. Placental hyperfusion
Constriction of small arteries
Reduced blood flow to multiple organs
Increased vascular permeability
Shift of extracellular fluid from the blood to interstitial space
Reduced blood flow and oedema
Hypertension, renal, pulmonary, hepatic disfunction & cerebral oedema
with cerebral disfunction and convulsion

14.  excess protein in urine
 decreased amount of urine
 low platelet count in blood
 intense headaches
 vision problems such as loss of vision, blurry vision, and sensitivity to
light
 pain in the upper abdomen, usually under the ribs on the right side
 vomiting or nausea
 abnormal liver function

15. • Pregnancy history: Most cases of preeclampsia happen in first
pregnancies. Previous pregnancies with poor outcomes could also
increase the risk of developing eclampsia.
• Patient age: Teen pregnancies and pregnancies in women over 35 have
an increased risk of developing eclampsia.
• Family history: Cases of preeclampsia or eclampsia in family members
could signal a genetic predisposition to the condition.
• Obesity: Women who are obese are at a higher risk of developing
eclampsia than others.
• High blood pressure: Patients with long-term high blood pressure are at
a higher risk of developing eclampsia than others.

16.  a lack of oxygen to the placenta which can cause slow growth,
low birth weight, or preterm birth of the baby or even stillbirth
 placental abruption, or the separation of the placenta from the
uterus wall, which can cause severe bleeding and damage to
the placenta
 HELLP syndrome, which causes loss of red blood cells,
elevated liver enzymes, and low blood platelet count, resulting
in organ damage
 eclampsia, which is preeclampsia with seizures
 stroke, which can lead to permanent brain damage or even
death

17. Laboratory tests:
 Blood tests: This checks kidney and liver function and whether the
blood is clotting properly.
 Fetal ultrasound: Doctors will closely monitor the baby’s progress to
make sure they are growing properly.
 Non-stress test: The doctor checks how the baby’s heartbeat reacts when
they move. If the heartbeat increases 15 beats or more a minute for at
least 15 seconds twice every 20 minutes, it is an indication that
everything is normal.

18.  Urine analysis: To check the presence of protein.
 Head CT scan: To assess intracranial haemorrhage.
 Transabdominal ultrasonography to estimate gestational age

19. S.N
O
Generic
name
Brand name Dose Frequ
ency
ROA Day-
1
Day
-2
Day-
3
1. Taxim Cefotaxime 1g BD IV + + +
2. Rantac Ranitidine 1A BD IV + + +
3. Voveran Diclofenac 1A BD IV + + +
4. Metrogyl Metronidazole 100ml TID IV + + +
5. Paracetamo
l
Acetaminophe
n
1gm BD IV + - -
6. Zofer Ondansetron 4mg BD IV + + +
7.
8.
Epidosin
IV fluids
Valethamate
(colwen)
DNS-20
RL-20
1ml
100ml
BD IV
IV
+
+
+
+
+
+

20.  Anticonvulsants:
1. MgSo4 – IV, 4g
2. Diazepu – IV, 5-10mg. < 30mg in 8hr
 Antihypertensives:
1. Hydralazine – IV, 5mg
2. Labetalol – IV, 20-30mg
3. Furosemide – IV, 20-30mg

21.  Loading dose magnesium sulphate:
 4 g IV over 20 minutes via controlled infusion device
 If seizures occur/ongoing while preparing magnesium sulphate
 Diazepam 5–10 mg IV at a rate of 2–5 mg/ minute (maximum dose of 10 mg) OR
 Clonazepam 1–2 mg IV over 2–5 minutes OR
 Midazolam 5–10 mg IV over 2–5 minutes or IM
 Maintenance dose magnesium sulphate
 1 g per hour IV via controlled infusion device for 24 hours after birth
 Then review requirement
 If seizures reoccur while receiving magnesium sulphate
 Magnesium sulphate 2 g IV over 5 minutes. May be repeated after 2 minutes
 Diazepam 5–10 mg IV at a rate of 2–5 mg/ minute (maximum dose of 10 mg) OR
 Midazolam 5–10 mg IV over 2–5 minutes or IM OR
 Clonazepam 1–2 mg IV over 2–5 minutes
 If impaired renal function
 Reduce maintenance dose of magnesium sulphate to 0.5 g/hour
 Ongoing serum monitoring

22.  Monitor
 BP and pulse every 5 minutes until stable then every 30 minutes
 Respiratory rate and patellar reflexes hourly
 Temperature 2nd hourly
 Continuous ^CTG monitoring
 Measure urine output hourly via IDC
 Strict fluid balance monitoring
 Check serum magnesium if toxicity is clinically suspected
 Therapeutic serum magnesium level 1.7–3.5 mmol/L
 Stop infusion
 Review management with consultant if:
 Urine output < 80 mL in 4 hours
 Deep tendon reflexes are absent or
 Respiratory rate < 12 breaths/minute

23. Thank you