Normal changes in pregnancy
Disorders
Screening, prediction and classification
Complications
Investigations
Management
Management of an eclamptic episode
History
Examination
Investigations
In addition to above
Discussion
Add from :
1. Ten teachers
2. Sri lankan guidelines
3. neet pg
4. academics usb folder
Neet pg
getstaional usualy after 20 weeks becase pressure drops until 20 weeks. so if high before 20 weeks then its probably chornic.. if persists after pregnancy then relabled as chronic.
So pregnant women with hypertension and and presenting with abdominal pain then it can be a hepatic failure and rupture
So a woman with preeclampsia presenting with placental abruption must think about hypervolemic shock and kidney failure
Not all women we take women the press is Mac hey go swimming would have gone to the same Natural History of increasing severity but sometimes they even percent with FMC without race blood pressure because of the loss of cerebral after radiation even with normal blood pressures
The most common cause of blindness is temorary
For important topics like preeclamsia and pph mst know the risk factors in and out because they can question each of that in mcqs. so go though pastpapers and see which lists are important and make lists of all those important for mcq. Like riskfactors and causes of important stuff.
but the utefine artery dopper isnt a very good predictor....must pay more attention to the risk factors if theyre are even if normal dopplers..
no other drug has been found to work for preclampsia - but only aspirin as a prevnattaive faactor
The reason why blood pressure doesn't drop off the delivery instead all the peripheral edoema gets back into the blood as the capillary is healingand therefore blood volume increases and blood pressure increases. That's the same reason why haemoglobin levels can fall after delivery 1. blood loss 2 flid moving from outside compartments to inside
Controlling blood pressure doesn't stop eclampsia because there other pathophysiological reasons for clampsia but controlling blood pressure helps tool prevent acute hypertensive complications like Inter cerebral haemorrhaging and abruption of plcaneta
oral nifedipine sed here is the immeidte released one not the sstained release one
terminate in end organ damage severe preeclapmsia or uncontrolled seevere eclampaisa bp or actual eclampsia
not for mild or moderate preclampsiaa without worsening signs and symptoms or sighs and symptoms of impending eclampsia
convulsions in pregnancy are eclampsia unless proven otherwise!!
the delivery of choice is iol though vaginal delivery. not ceasarian. all of these dissorders are not infications for caesarian unless there are other clear indications for ceasarian.
adenosine is an inhibirtory neuro transmitter
zusan regime saves the need for painfl intramusclar injections
if still convlsing, after 15 minutes can repeat half the loading dose. and if still again repeat half the loading dose...and if still then must use lorazepam and stronger anti epileptics and take help from medicine physicians.
urine output needs to be monitored because excerteted though urine so need to monitor urine out put, otherwise can cause toxicity if urine outptless.
Can monitor magnesium levels by clinically, bt if rine otput less than can use serum mag levels. ser magnesim isnt usually done routinely.
if knee jerk absent then omit the next dose and continue.
if more than that, then calcim gluconate can be given as antidote.
must contine monitor even after delivery beuse the patient can go into polmonary oedema. (fluid shift from outside to the inside vascular compartment)
that is why need to have strict input output monijtoring...and make sure not overhydrtate the patient.
discharge after 48 hours stable.
when moniotring rather chek the knee jerk than the ecg becase ecg is the later thing to go off. the knee jerk is lost at first.
knee jerk before treament to check early warning of eclamspia. knee jerk after treatment for magneium slphate toxicity
why to check knee jerk in pre eclampsia patients ??
an early warning indication of cns depression. early sign. severe preelampsia.
In labour
