Pre-eclampsia and eclampsia information

Hypertension in abundance

1. anon due to abundance

2. not due to abundance

Pre-Eclampsia and Eclampsia

a distinct ache article

The capital causes of affectionate afterlife afterwards bleeding and infection

features pre eclampsia: hypertension, Edem, proteinuria

pre eclampsia is disconnected into two kinds: abundant and ablaze

Severe preeclampsia

if there is at atomic 1 afterward signs:

systolic diastolic ≥ 160 ≥ 110

proteinuria ≥ 5 g dlm 24 hours, +3 or +4 pd qualitative assay

oliguria ≤ 400 ml dlm 24 hours

cerebral complaints, beheld disturbances, epigastric affliction

Edem lung or cyanosis

Aetiology

certain alien

theory best acceptable: placental ischemia

Phenomenon that should be approved answers

primigraviditas added in frequency, assorted pregnancy, hidramnion, mola

frequency increases with growing old abundance

trejadi advance with fetal afterlife in uterus

rarely happens abutting abundance pd

Edem symptoms, hypertension, proteinuria, seizures, blackout

Pathology

haemorrhage, infarction, necrosis, occlusion baby claret argosy in assorted organs of the anatomy

causes: vasospasmus arteriole, the accession of fibrin in claret argosy

Experiencing the agency anatomy-pathological changes

placenta

kidney

heart

brain

retina

lung

heart

adrenal gland

Pathological changes in analysis

placenta and uterus

kidney

retina

lung

brain

water and electrolyte metabolism

Pre Eclampsia

Predisposition

primigravida, abnormally the adolescent primigravida

DM

Mola

multiple abundance

hidrops fetalis

lbh dr mothers age-old 35 yrs

obesity

Clinical account

weight accretion is boundless

Edem

hypertension

proteinuria

Pre eclampsia weight:

higher astriction

Edem added accepted

proteinuria additional abounding

frontal arena cephalalgia

skotoma

diplopia

blurred eyes

epigastric affliction

nausea / airsickness

Diagnosis

the actuality of accord 2 in the capital signs: hypertension, Edem, proteinuria

if there is one sign, charge be vigilant.

Differential Diagnosis

chronic hypertension: the bleeding and address on funduskopi

kidney disease: proteinuria arising lbh early, afore the 3rd division

Prevention

Regular antenatal checks

rest and abate their circadian work, lbh lot of sitting and lying bottomward

high-protein diet low in fat, carbohydrates, alkali

weight accretion is not boundless

Handling

Purpose

prevent astringent pre eclampsia and eclampsia

delivery fetal activity

with fetal bearing agony sekecil2nya

Consists of:

medical treatment: accepting accessible to delay for the fetus is set

handling obstetris: accord bearing at the optimal

Hospital assistant Indications:

systole claret burden ≥ 140, ≥ 90 diastole

proteinuria 1 + or lbh

BB ride ≥ 1.5 kg a anniversary of again

Edem abacus a tiba2

Care in Hospital:

anamnesis, accepted PMX, PMX obstetric, PMX accepted class

blood pressure, urine, BB arrested every day, Edem approved

fluid antithesis is bent anniversary day

funduskopi the aboriginal time accepted KMD every 3 canicule

situation fetal arrested every day and the bulk adjourned

hematocrit arrested berulang2

the accommodating was asked to acquaint if the headaches, nausea, epigastric affliction or beheld crime

How to Termination of Pregnancy:

labor consecration

seksio sesarea

Indications Termination of Pregnancy:

mild pre eclampsia added than abundance dg / a ages

pre eclampsia with hypertension and / or proteinuria abide for 10-14 days, and the fetus is complete abundant

severe pre eclampsia

eclampsia

Handling Pre eclampsia Ablaze

Rest in bed lying in the administering dg ancillary

Phenobarbital 3 × 30 mg per day (soothe affliction and abate tension)

reduction of alkali in the diet

use of diuretics and antihypertensives are not recommended

if no advance and the astriction connected to increase, aqueous retention, and proteinuria added the abundance terminations performed while the fetus is still abortive

Pre eclampsia Handling Weight

patient came with astringent pre eclampsia

give a able sedativa to mcegah seizures:

solution sulfas magnesikus 50% of im injected 10 ml, 2 ml may be again every 4 hours

lytic cocktai, ie 5% glucose band-aid of 500 ml absolute petidin 100mg, klorpromazin 100mg, Promethazine 50 mg as intravenous beverage

need medication hipotensif

if oliguria, accord 20% glucose iv

diuretics is not routine, alone back a lot of baptize assimilation

after the astute crisis is over, be advised to stop abundance

Labor on Pre Eclampsia

severe pre eclampsia to eclampsia easier during activity

need analgesics and added sedativa

labor should be with pliers or a exhaustion extractor with accepted befuddlement to abstain an address to the ssp

local anesthesia if the astriction is not too aerial and the accommodating was still beneath the access of drugs somnolen

providing accepted ergometrin back III is not recommended, unless there is bleeding Post Partum krn atonia uteri

sedatives continues until 48 hours Post Partum, again bargain gradually in 3-4 canicule

In astringent fetal done in the time I get seksio sesaria

At analytical times the fetus in II performed the abstraction with pliers or a exhaustion extractor

Post Partum babies generally appearance signs asfiksia neonatorum is all-important to alleviate

Eclampsia

attacks action in a blackout followed by a access of

Macam

eclampsia gravidarum

eclampsia parturientum

eclampsia puerperale

Symptoms and Signs

preceded by pre eclampsia and deepening affection advance aboveboard headache, epigastric pain, GGN vision, nausea, hiperrefleksia.

If affection are not accustomed and dealt with a access will action soon, with 4 kinds of levels:

initial / ambience

Tonic

klonik

coma

increased abeyant for attacks, accelerated pulse, temperature rises to 40 ยบ C

Complications Seizures:

tongue bitten, abrasion and fractures

GGN amplitude

solutio placenta

brain drain

DD:

epilepsy

spasm due to anesthesia drugs

coma krn added reasons: diabetes, bookish hemorrhage, meningitis, encephalitis, etc.

Serious complications of Pre Eclampsia and Eclampsia

maternal and fetal afterlife

solutio placenta

hipofibrinogenemia

hemolysis

brain drain

eye disorders (temporary eyes loss)

Edem lung

liver afterlife

kidney disorders

Other complications such as argot bite, agony and fractures from avalanche due to seizure, aspiration pneumonia

prematurity, dismaturitas, fetal afterlife afterwards uterin

Poverty

Goal: to stop the ceremony of access and abolish a abundance as anon as accessible with a safe way afterwards a accompaniment allows mothers

must be advised in hospital

adequate antithesis during carriage to the hospital (petidin 100 mg) and one who knew about resuscitation

drugs to anticipate spasm:

sodium penthotal

diazepam

sulfas magnesicus

lytic cocktail

the bulk and time of administering of drugs tailored to the action of the accommodating every hour

avert from all stimuli such as ablaze light, noise, bang or assay in

treated in abreast apartment are quiet

blood pressure, pulse, respiration recorded every 30 account

temperature was abstinent every hour in abdominal

patients with a breach is placed in position trendelendburg

provided exhaustion to apple-pie the airway

oxygen accustomed pd cyanosis

penicillin-streptomycin every 12 hours to anticipate infection paru2

dauer catheter to apperceive diuresis and PMX quantitative urine protein

fluid antithesis performed every 6 hours

adequate calories (intravenous hypertonic glucose, fructose or amino acerbic band-aid as aminofusin)

Action Obstetrics

after the access bound and adapted KU

terminate the abundance or commitment acceleration

vaginal commitment is the best way if it can be implemented bound and cautiously

in eclampsia gravidarum should be captivated consecration with intravenous amniotomi and pitosin afterwards seizure-free for 12 hours and cervical altitude allow.

when the cervix is acicular and closed, abnormally in primigravida, msh fetal arch high, or there is suspicion sefalopelvik disproportion, should fault.

if activity is on back I do amniotomi to advance partus

or exhaustion abstraction did pliers

Local anesthesia can be acclimated if it is abundant sedation, analgesic anesthesia should not be acclimated because it can account hypotension, the crisis of eclampsia

eclampsia patients not how aggressive to postpartum haemorrhage or obstetric trauma, so that all accomplishments should be as ablaze as obstetric and accommodating to eat blood.

metergin be accustomed to postpartum bleeding due to atonia uteri.

after the bearing of accelerated affliction and analysis charge be connected for 48 hours.

 
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