Question
Explain eclampsia and its management in hospital and care during fit.
Answer :
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Eclampsia is a serious obstetric emergency characterized by the occurrence of generalized tonic-clonic seizures in a pregnant or recently delivered woman with pre-eclampsia. It usually occurs after 20 weeks of pregnancy, during labour, or in the postpartum period. It may develop even when blood pressure and other signs of pre-eclampsia are not very severe. Eclampsia can cause serious complications for both the mother and fetus, including cerebral hemorrhage, aspiration, hypoxia, placental abruption, renal failure, pulmonary edema, and maternal or fetal death. Early recognition and prompt treatment are therefore essential. Management of eclampsia in the hospital requires immediate stabilization of the mother, control and prevention of seizures, control of severe hypertension, assessment of the fetus, and timely delivery. The woman should be admitted to a well-equipped obstetric unit, preferably an intensive care or high-dependency area. A multidisciplinary team, including an obstetrician, anesthetist, nurses, and pediatric or neonatal staff, should be involved. The first priority is to maintain the airway, breathing, and circulation. The woman should be placed in the left lateral position to reduce the risk of aspiration and improve venous return. Oxygen should be administered when required, and oxygen saturation should be monitored. Suction equipment, airway devices, and resuscitation facilities should be readily available. Intravenous access should be established, and blood samples may be collected for complete blood count, platelet count, renal and liver function tests, coagulation studies, and blood grouping. Magnesium sulfate is the drug of choice for controlling eclamptic seizures and preventing recurrent fits. It is generally administered according to an established hospital protocol, using an intravenous loading dose followed by maintenance
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