project

2. Preeclampsia when complicated with
grandmal seizures (generalized tonic-
clonic convulsions) or coma is called
eclampsia.It is derived from greek word
meaning “ like a flash of lightening”.
DEFINATION:-

3. Causes of convulsions :-
1.Anoxia- spasm of the cerebral vessels increased
cerebral vascular resistance fall in cerebral
oxygen consumption anoxia
2.Cerebral edema
3. Cerebral dysrhythmia- increases following anoxia or
edema

4. Eclamptic convulsions or fits are divided in to four stages-
1. Premonitory stage-The patient becomes unconcious.
There is twitching of muscle of the face, tongue and limbs.
Eyeballs roll up.This stage lies up to 30 seconds.
2.Tonic stage-The whole body undergoes in to tonic spasm-
limbs are flexed and hands clenched. Respiration ceases
and tongue protrude between the teeth. Cyanosis appears.
This stage lasts for 30 seconds.
Clinical features:_

5. 3. Clonic stage- All the voluntary muscles undergo alternate
contraction and relaxation. The twitching starts on the face
and involve one side of extremities and ultimately the
whole body is involved in the convulsion. Bitting of the
tongue occurs. Breathing is stertorus and blood stained
frothy secretion fills up the mouth,cyanosis disappears.This
stage lasts for 1-4 minutes.

6. 4. Stage of coma - Following the fit,the patient
passes under the state of coma.
The fits are usually multiple,recurring at
intervals.When it occurs in quick succession ,it is
called “STATUS ECLAMPTICUS”.

7. ONSETS OF FITS- It occurs in 3rd
trimester (>50%) .
1- Antepartum(50%): Fits occur before the onset of labor.
2- Intrapartum(30%): Fits occur for the first time during
labor.
3- Postpartum(20%): Fits occur for the first time in
puerperium usually with in 48-72 hours of delivery.

8. 1. Injuries-Tongue bit,bed sore
2. Pulmonary complication-Edema,
Pneumonia,ARDS,Embolism.
3. Hyperpyrexia
4.Renal failure
5.Neurological deficits
6. Disturbed vision- Due to retinal detachment or ocipital
lobe ischemia.
Matenal complications of Eclampsia :-

10. 1.Death
2. Prematurity
3. Placental infarction
4. Fetal hypoxia
5.IUGR ( Intrauterine growth retardation)
6. Sepsis
NEONATAL & FETAL COMPLICATION:-

12. 1.ANTICONVULSANT & SEDATIVE THERAPY
Aim- to control fits and to prevent convulsion.
Magnesium sulphate is a drug of choice,it acts as a
membrane stabiliser and neuroprotecter.
It reduces motor end plate sensitivity to acetylcholine, it
induce cerebral vasodilatation,dilate uterine arteries.
MANAGEMENT:-

13. Benefits of magnesium sulphate :
1.Control fits effectively without any depression effect to
the mother or infant.
2. It reduce risk of recurrent fits.
3.It reduce maternal death rate at 3%
OTHER REGIMEN ARE:
1.Phenytoin 3. Promethazine
2. Diazepam

14. 2. ANTIHYPERTENSIVE & DIURETICS
Drugs commonly used are: Hydralazine,
Labetalol,calcium channel blocker, nitroglycerin.
3. STATUS ECLAMPTICUS:
Thiopentone sodium 0.5 gm dissolved in 20 ml of
5% dextrose is given slowly.

15. For pulmonary edema & ARDS- Furosemide 40 mg I.V. followed
by 20gms of mannitol I.V. Aspiration of mucus from tracheo-
bronchial tree by suction appratus is done.
For heart failure- Digitalis , oxygen inhalation.
For Hyperpyrexia- Antipyretics
For psychosis- Chlorpromazine or trifluoperazine is effective.
Treatment of Complication:-