Fetal mortality from eclampsia
Written by Dr.ChrisThis is high in eclampsia — 30−60 per cent. The main reason being pre−eclampsia itself, prematurity and the sedatives employed.
A brief summary of the treatment of eclampsia carried out at the Government Hospital for Fetal mortality.
Eclamptic patients brought to a primary health centre should be transferred to a referral hospital after administering a good sedative. […]
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Maternal mortality from eclampsia
Written by Dr.ChrisMaternal mortality from eclampsia is high, especially in those who had no antenatal care. The common causes of death are 1) cerebral hemorrhage, 2) pulmonary oedema, 3) renal failure, and 4) hyperpyrexia. To reduce maternal mortality, it is not enough to control the convulsions but these complications should also be controlled. Herein lies the value […]
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Pregnancy:After-care
Written by Dr.ChrisThese patients require to be carefully watched even after the delivery is over. Sedation — less intensively — should be continued for 48 hours. In some cases, the convulsions are easily controlled and the pregnancy continues. It is not essential to terminate pregnancy, especially when the fetus is premature. The patient should be carefully observed, […]
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Eclampsia: Obstetric management
Written by Dr.ChrisObstetric management: Forcible methods of delivery have no place in the management of eclampsia. Induction of labour by ARM would be the treatment of choice in patients in whom the convulsions cannot be controlled within 8−10 hours of start of sedative treatment on a planned schedule, cutting short the second stage of labour by outlet […]
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Eclampsia:Hypotensive management
Written by Dr.ChrisHypotensive management: A state of hypertension is said to predispose to eclamptic convulsions. The occurrence of eclamptic convulsions is usually preceded by a sudden rise in blood pressure and it was, therefore, thought that the reduction in blood pressure may be useful in the management of eclampsia. Under the influence of hypotensive agents, the blood […]
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Eclampsia:Sedative line of treatment
Written by Dr.ChrisThe sedative line of treatment: The modern management of eclampsia consists in the administration of sedatives on a planned time schedule. If after some hours of such treatment the convulsions are not controlled, pregnancy is terminated either by artifical rupture of membranes or by lower uterine segment caesarean section.
Many sedatives and their combinations have been […]
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Treatment of Eclampsia
Written by Dr.ChrisThe treatment is considered under two heads
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Factors influence prognosis in eclampsia
Written by Dr.ChrisVarious factors influence the prognosis in eclampsia. They are:
I. Parity: The prognosis is more grave in multiparae.
2. The time of onset of convulsions: In our experience, antepartum eclampsia has the,high− est maternal mortality.−The mortality rate for dfeient types ofecla—mpsia in a series of 1,151 cases is given below:
Type of No of No of Percentage
eclampsia cases […]
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Prognosis of Eclampsia
Written by Dr.ChrisThe prognosis with any particular line of treatment should always be based on the study of a large number of cases treated. Variations do occur as regards the severity of the disease. It is not at all uncommon to find a series of cases responding very favourably to a particular line of treatment, but sooner […]
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Complications of Eclampsia
Written by Dr.ChrisInjuries varying from bruises to fractures may result. The tongue is usually bitten and in some cases it may be so badly injured that it gets swollen, may fall back and occlude the glottis during the period of unconsciousness, causing suffocation and even fatal asphyxia.
Cerebral hemorrhage, hyperpyrexia, pulmonary oedema, renal failure, psychosis, neurological lesions […]
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Diagnosis of Eclampsia
Written by Dr.ChrisPregnancy may be complicated by diseases like epilepsy, hysteria, cerebral tumours, meningitis and other diseases which give rise to convulsions. These have to be borne in mind in the differential diagnosis of eclampsia. However, when in a pregnant woman with no history of pre−existing convulsive disorders, fits occur in association with proteinuria, hypertension and oedema, […]
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The eclarnpic convulsion, or the fit
Written by Dr.ChrisWhen the woman actually develops the convulsive attack, four stages are recognised:
1. The premonitory stage
2. The tonic stage
3. The clonic stage
4. The stage of coma
The premonitory stage: During this stage the patient becomes unconscious, the pupils dilate, the eyes are turned to one side and fixed, or roll from side to side; twitchings of the […]
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Clinical signs and symptoms of eclampsia
Written by Dr.ChrisIn a large number of cases of eclampsia, the signs and symptoms of pre−eclampsia are present. In cases of the fulminant variety, no signs or symptoms may be present, and a fit may be the first warning. The chief symptoms of an imminent attack of eclampsia are headache, giddiness, disturbances of vision such as dimness, […]
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ECLAMPSIA
Written by Dr.ChrisThis is a convulsive disease occurring in pregnant, parturient or pUerperal women, usually characterised by high blood pressure, albuminuria, oedema, and such symptoms as headache, dizziness, disturbances of vision, epigastric pain, convulsions and coma, sometimes ending fatally.
Eclampsia is a preventible disease. Efficient antenatal care has almost eliminated this disease in countries where such care is […]
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THE NEPHROTIC SYNDROME
Written by Dr.ChrisThis complication is uncommon. Marked oedema is its main feature and, along with it, heavy protein loss in the urine. The prognosis is a little better than in other varieties of chronic renal disease. Because of the heavy protein loss (albumin), the serum proteins tend to be low. It may be helpful to replace some […]
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