Diagnosis and treatment of eclampsia

Diagnosis of eclampsia in most cases is not difficult. Recognition is based on the typical convulsive seizures, swelling, hypertension, albuminuria. Atlanticheskii fit like epilepsy. Error detection is more likely to occur in those cases when the former only in childhood epilepsy resumed during pregnancy. Epilepsy there are no signs of late toxicosis, convulsions appear suddenly without preceding symptoms of pre-eclampsia. Diagnostic errors happen and in relation to recognition of pre-eclampsia: a pain in the epigastric region can be mistaken for gastrointestinal disease, vomiting attributed to food "etching. In all these cases the presence of signs of late toxicosis should suggest the possibility of pre-eclampsia.
Forecast in each case eclampsia is a serious. Eclampsia can be accompanied by severe brain, liver, kidneys, and heart. Possible death. Adverse effects eclampsia affects the fetus; in eclampsia increased perinatal mortality due to preterm delivery and prenatal by asphyxia fruit.
Treatment in eclampsia aims prevent seizures, to get hypotensive effect, improve diuresis. Most full in your case it is done in a hospital. Transportation must be carried out extremely carefully (stretchers, ambulance car) accompanied by a doctor or medical assistant (midwives). Before transporting pregnant intramuscularly (in the area of the buttocks) magnesium sulfate (20 ml 25% solution) and chlorpromazine (1 ml of 2.5% solution). Hospital pregnant should be placed in a darkened chamber and to create an absolute silence. All manipulations (injections, midwifery research) should be done only under essential-oxygen anesthesia. The midwife must constantly be in the house; when signs of incipient attack (increases the excitation of the patient, increased blood pressure, pulse becomes tense, the pupils dilate) is given anesthesia; between indigenous teeth enter the mouthpiece and down or metal spoon, wrapped in several layers of gauze.
Food and drink during a seizure, shall be terminated.
After a seizure, the mouth should be exempt from saliva and foam, for which the patient is placed on the side (to dripped saliva), and mouth clean topferm of gauze (to prevent aspiration of saliva). For the prevention of pneumonia patient should be rotated from side to side and apply the dry banks.
To improve the condition of the patient and accelerate the delivery useful in eclampsia to do early and wide gap membranes. Speedy delivery and cesarean section when a typical eclampsia contraindicated; to accelerate delivery should be careful delivery with the use of obstetric operations.
Currently, the treatment of eclampsia spend on a modified scheme centuries Stroganov: 1) after the seizure, when the patient begins to breathe, enter barbitala-sodium or omnopon (single dose: barbitala-sodium - 1 ml of 20% solution; omnopon - 1 ml of 2% solution); magnesium sulfate - 24 ml of 25% solution intramuscularly; 2) after 30 minutes introduce a solution of magnesium sulfate; 3) after 2 hours of starting treatment again introduce the barbitala-sodium or omnopon; 4) after 3 hours 30 minutes (after 5 an hour. 30 minutes from the beginning of treatment) again enter magnesium sulfate at the same doses; introduction repeated after 6 hours, and then - in 8 hours. (i.e. over 19 hours. 30 minutes from the beginning of treatment). During the first two periods, when the forerunners of seizure give essential-oxygen anesthesia.
In the first day, and in severe on the second day appointed hungry diet sharp reduction of the liquid (a few spoons of tea or juice) and with the exception of salt; pregnant should be administered intravenously large quantity of glucose.
Prevention of eclampsia is a timely recognition of initial symptoms of any form of late toxicosis, early admission and appropriate therapy.