Emergency care for eclampsia. Preeclampsia, eclampsia Algorithm of actions for eclampsia in pregnant women

Target: assess the practical skills of the graduate providing emergency care for eclampsia

Indications- Seizures in eclampsia

Contraindications- No

Possible Complications- repeated seizures, eclamptic coma.

Resources– model of a woman, 25% magnesium sulfate solution, spatula, tongue holder, 20 ml syringe, 500 ml saline solution, intravenous infusion system, alcohol, cotton wool, tourniquet

Action algorithm:

1. In case of seizures, call all free personnel and the resuscitation team without leaving the patient.

2. Do the following at the same time:

· free the airways by opening the mouth with a spatula or a spoon wrapped in gauze, pull out the tongue with the tongue holder.

Remove saliva from the oral cavity, as soon as an inhalation occurs, ensure free access of air.

After stopping the seizures intravenously, enter the starting dose of magnesium sulfate - 25% -20 ml for 10-15 minutes.

3. Start an intravenous infusion of 320 ml saline with 80 ml - 25% magnesium sulfate solution

4. Under control of blood pressure and ongoing magnesium therapy, transfer the patient to a stretcher and transport to the intensive care unit of the nearest maternity hospital.

NOTE

With eclampsia, delivery should occur after the stabilization of the patient's condition, but no later than 12 hours from the onset of seizures.

Standard "Emergency care for severe preeclampsia".

Target: assess the practical skills of a graduate in providing emergency care for severe preeclampsia

Indications- severe preeclampsia

Contraindications- during a seizure

Possible Complications- Seizures, eclamptic coma.

Resources– model of a woman, 25% magnesium sulfate solution, 20 ml syringe, 500 ml saline solution, intravenous infusion system, alcohol, cotton wool, tourniquet

Action algorithm:

1. Diagnose: "Severe preeclampsia" if one of these symptoms is present: headache, pain in the epigastric region, visual disturbances, flies before the eyes, nausea, vomiting, against the background of arterial hypertension (140/90 mm Hg and above) and proteinuria.

2. Call all free personnel and the resuscitation team without leaving the patient.

3. Do the following at the same time:

Lay the pregnant woman on a flat surface, avoiding damage and turn the patient's head to one side.

Intravenously enter the starting dose of magnesium sulfate - 25% -20 ml for 10-15 minutes.

4. Start an intravenous infusion of 320 ml of normal saline with 80 ml of 25% magnesium sulfate solution.

5. When blood pressure is equal to or higher than 160/100 mm Hg. regulate blood pressure by prescribing 10 mg of nifedipine sublingually, again after 30 minutes 10 mg under the control of blood pressure (maintain blood pressure at 130/90-140/95 mm Hg).

6. Under control of blood pressure and ongoing magnesium therapy, transfer the patient to a stretcher and transport to the intensive care unit of the nearest maternity hospital.

NOTE If signs of an overdose of magnesium sulfate appear, inject 10 ml of a 10% Ca gluconate solution intravenously over 10 minutes.

Amniotomy standard.

Target- opening of the fetal bladder.

Indications- before labor induction, labor stimulation, weakness of labor Contraindications- threatening conditions of the mother or fetus

Possible Complications- prolapse of small parts of the fetus, ascending infection, injury to the vessels of the fetal bladder, detachment of a normally located placenta

Resources- a gynecological chair, an individual diaper, sterile gloves, an antiseptic for treating the external genitalia of a woman, a branch of bullet forceps.

Action algorithm:

1. Introduce yourself.

2. Explain to the woman the need for this operation.

3. Take the patient's informed consent for the procedure

4. Lay the woman on the gynecological chair with a disposable bed underneath her.

5. Treat the woman's external genital organs with an antiseptic solution, put a sterile diaper on the woman's stomach.

6. Perform hygienic hand disinfection.

7. Wear disposable gloves on both hands.

8. Spread the labia with the fingers of the left hand, sequentially insert into the vagina

index finger, then the middle finger of the right hand.

9. Enter the branch of the bullet forceps into the vagina between the index and middle

fingers.

10. Puncture the amniotic sac.

11. Enter the index finger and then the middle finger into the hole in the fetal bladder, gradually expand the hole, remove the membranes from the head. Release amniotic fluid slowly, under the control of the fingers (prevention of prolapse of small parts, detachment of a normally located placenta).

13. Pull out your fingers.

14. Remove gloves and place in safe disposal box.

15. Wash your hands with soap.

16. Write down the data in the history of childbirth.

NOTE.

With polyhydramnios, a small hole is made and the water is slowly released. It is necessary to control the rate of outflow of water, since with a quick and sharp outflow of them, small parts of the fetus may fall out. After the water breaks, a woman is recommended to lie down for 30 minutes.

Immediate measures of action - first aid for eclampsia, must be carried out clearly and consistently to prevent the irreversible consequences of the pathology. Eclampsia is a complication of the last months of pregnancy with severe toxic manifestations. Violations of the state of health are manifested in the form of increased pressure, convulsive seizures, coma. It can occur before childbirth, during and in the first days after childbirth. First aid is based on relief of symptoms.

Causes and symptoms of pathology

The main causes of eclampsia include existing pathologies of the cardiovascular system associated with increased blood pressure and kidney disease. Risk factors that increase the possibility of complications:

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age of the first pregnant woman up to 20 and after 35 years;
common diseases: arterial hypertension, diabetes mellitus, systemic lupus erythematosus, rheumatoid arthritis, colitis, gastritis;
conditions of preeclampsia and eclampsia in close relatives;
multiple pregnancy;

Influence on the course of pregnancy has a woman's compliance with medical prescriptions. The basic rules are the development of the correct daily routine, a balanced diet, being in the fresh air, maintaining a stable psycho-emotional background and giving up bad habits. Violation of the norms increases the risk of complications of toxicosis.

Before the onset of eclampsia, preeclampsia occurs. appear:

nausea, vomiting, stomach pain;
headaches;
the appearance of swelling of the body;
incipient visual disturbances;
coordination disorders;
increased excitability.

At the first symptoms of eclampsia, you need to see a doctor, as this threatens the life of the child and mother.

An attack of eclampsia is accompanied by:

increased blood pressure;
dizziness;
rise in temperature;
spasms of the facial muscles;
strengthening of coordinating, visual disturbances;
convulsions, convulsions, numbness of the extremities;
increased nausea, vomiting and foaming at the mouth;
loss of consciousness.

With pathology, disorders of the whole organism occur. The central nervous system is characterized by increased excitability, which can provoke seizures. To remove possible irritants, it is necessary to avoid bright light, pain, sharp and loud sounds, nervous shocks.

Stages and forms of eclampsia

In the development of an attack of eclampsia in pregnant women, four stages are distinguished, which are characterized by a gradual increase in symptoms and manifestations, followed by their decrease and restoration of the body's vital functions. A description of the development of eclampsia is presented in the table:

Stage	Duration	Characteristic
Preconvulsive	20-30 seconds	Small contractions of the facial muscles, drooping of the corners of the mouth, rolling the eyes.
			tonic convulsions	10-30 seconds	Tension, contraction, spasm of the muscles of the body. Difficulty, cessation of breathing. Blueness of the face.
Clonic seizures	20-90 seconds	Violent convulsions of the whole body. No breathing, no pulse.
			Seizure Resolution	–	The appearance of hoarse breathing, pulse, foam mixed with blood from the mouth. The face takes on a normal color. Coming to consciousness or falling into a coma.

Forms of manifestation and clinical signs are presented in the table:

Severe eclampsia can be fatal.

The severity of seizures is determined by their duration, number, time intervals between them and the patient's well-being. If a woman does not regain consciousness for a long time, damage to vital organs, especially the brain, is possible, with subsequent death for the pregnant woman and the fetus.

Complications of pathology are manifested by such violations:

pneumonia, pulmonary edema;
deterioration of brain activity;
kidney failure;
suffocation;
premature detachment of the placenta;
hypoxia, fetal death;
cerebral hemorrhage, cerebral edema.

Algorithm of actions for symptoms of pathology

The provision of emergency care should be carried out strictly in a certain order. Since pathology gives serious complications and poses a threat to the mother and fetus, and at the first sign of beginning seizures, call an ambulance. Before the doctors arrive:

Place the patient on the pillow with the left side and cover with blankets.
Open your mouth and fix the position of the tongue, preventing it from being swallowed and suffocated.
Wipe mouth to remove vomit, foam and mucus.
If necessary, massage the heart.

The main attention in the treatment of the disease is directed to the elimination of convulsive seizures.

Next, the patient is transferred to the intensive care unit. The room should be soundproof, with darkened windows and dim lights. Diagnostic measures are carried out under anesthesia to eliminate an additional irritating factor. Ensuring the vital activity of the body during convulsive seizures is provided by the following resuscitation measures:

artificial ventilation of the lungs to maintain breathing;
the introduction of intravenous diuretic drugs;
catheterization of the bladder to ensure the excretory functions of the body;
intravenous administration of glucose to lower intracranial pressure, stabilize cardiac activity;
drip or intravenous administration of drugs to improve the activity of the hematopoietic system;
the use of sedatives to relieve excitation of the central nervous system.

Emergency care for pathology is aimed at maintaining the work of all organs and systems of the body, especially the kidneys, liver, heart and brain. When providing first aid, the following indicators are constantly monitored:

blood pressure;
pulse rate;
completeness of breathing;
work of the urinary system.

From the earliest stages of pregnancy, a special system of interaction between the mother's body and the fetus is formed. In gynecology, it is called the mother-placenta-fetus system. Thanks to her, the woman's body does not reject the embryo, but vice versa: it contributes to its preservation and development.

However, some pregnant women may experience a disruption in the functioning of this system, which leads to eclampsia, a condition in which there is dysfunction of the vital organs of the mother, which poses a direct threat to both the life of the woman and the life of the fetus.

Until now, there is no consensus on why this ailment begins, but it is reliably known that its appearance is typical only for pregnant women, women in childbirth and puerperas. In obstetric practice, two states of late gestosis are distinguished: preeclampsia and eclampsia, but what is it in simple terms?

Preeclampsia- this is a condition in which damage to the nervous system, liver, kidneys occurs, arterial hypertension develops.

is a condition that requires urgent hospitalization, it can develop in patients with preeclampsia, and also exist as an independent form of a serious illness.

Causes of eclampsia in pregnant women

Since eclampsia is a violation of the functioning of the "mother-placenta-fetus" system, the causes are diseases that a woman already had before conceiving a child. During pregnancy, these pathologies can be a trigger for the onset of a severe degree of preeclampsia. Among the causes of eclampsia are the following:

Fetoplacental insufficiency (FPI) is a condition in which the blood flow of the placenta begins to function poorly. Only a doctor can assess the condition of the arteries with a Doppler study.
Thrombophilia is a genetic disease that involves a special mutation of the genes that provoke thrombosis. During pregnancy, thrombophilia becomes active and in the later stages is the cause of the development of FPI.
Mutations of the eNOS gene - affect the functioning of blood vessels. In the presence of a genetic defect, the woman's body may perceive the fetus as a foreign body and try to get rid of it.
Defects in the attachment of the placenta to the walls of the uterus - cause deterioration in the nutrition of the fetus, provoke the appearance of FPI. With this pathology, a violation of blood flow can form both gradually and suddenly.

In addition to causes, there are risk factors for eclampsia and preeclampsia. At the very beginning of pregnancy, when registering, the gynecologist should pay attention to their presence and prescribe appropriate therapy to the patient so that the risk factors do not provoke the onset of severe preeclampsia.

Chronic hypertension;
Multiple pregnancy;
The presence of eclampsia or preeclampsia in an obstetric history;
The presence of eclampsia or preeclampsia in the obstetric history of the mother, grandmother, aunt or sister;
Old-term women (age over 40 years at the time of pregnancy).

Particular attention should be paid to the patient's condition if one or more risk factors for the development of preeclampsia are combined with the fact that the woman is carrying her first pregnancy.

Types of disease

In general, eclampsia can be divided into two types: according to the severity of the disease and the time of its occurrence. Depending on this, the treatment regimen will be determined and the risk to the health of the mother and fetus will be assessed.

The Russian classification of the stages of development of preeclampsia is somewhat different from that adopted in European countries. According to domestic experts, preeclampsia is the initial stage of eclampsia.

The severity of the disease

Mild preeclampsia - suggests blood pressure in the range of 140 - 170/90 - 110 mm Hg. Art. At the same time, proteinuria will be determined in the analysis of urine - (more than 0.3 g / l).
Severe preeclampsia - suggests blood pressure above the border of 170/110 mm Hg. Art. Proteinuria is pronounced.

Time of onset of the disease

Eclampsia during pregnancy - occurs most often, poses a threat to the life of the mother and child. Treatment is complicated by the fact that the fetus may not be able to tolerate certain seizure medications.
Eclampsia during childbirth - occurs in about 20% of all cases, poses a threat to the life of a woman and a child. In this case, the provocateur of seizures is generic activity.
Eclampsia after childbirth - occurs very rarely, develops within a day after the birth of the child.

Eclampsia signs and symptoms

Despite the diversity of species, the signs of eclampsia have a certain similarity, so they can be distinguished into a general list:

Increased blood pressure - depending on how high it has increased, the doctor will determine the severity of the disease.
Edema - the more severe the patient's condition, the more severe the fluid retention in her body. Swelling, mainly, the upper part of the body (face, hands).
A series of convulsive seizures are numerous, lasting 1-2 minutes. The intervals between convulsions are small. Loss of consciousness is short-lived.
Status eclampsia is a series of seizures in which the patient is in a coma and does not regain consciousness.

Characteristics of a seizure

The attack begins with involuntary contractions of the mimic muscles of the face. After a short period of time, the entire musculature of the body is involved in the process. The woman loses consciousness, clonuses of the limbs appear. After a series of clonuses, a coma sets in.

Diagnostics

The diagnosis is complicated by the fact that eclampsia does not have specific symptoms that would correspond only to it. Convulsions, edema and proteinuria can be symptoms of other diseases that have nothing to do with preeclampsia.

Currently, the problem of determining eclampsia is being actively studied, and to make a diagnosis, doctors use special examinations and tests that reveal the initial stage of the disease - preeclampsia:

Systematic measurement of blood pressure. Moreover, to confirm eclampsia, it is necessary to monitor the state of blood pressure in dynamics.
Urinalysis to determine the amount of protein. The daily sample () is important here.

If the indicators indicate the presence of preeclampsia, then subsequent convulsive seizures will indicate that the pathological processes in the woman's body have entered the most difficult stage of their development - eclampsia.

Since severe degrees of preeclampsia suggest the presence of convulsive seizures, self-medication must be completely excluded. First aid for eclampsia will be reduced to the following:

Call an ambulance (most likely they should send an ambulance).
Lay the woman on her left side, build rollers from blankets around her. This precaution will help the patient avoid injury before the arrival of doctors. In addition, this position will ensure the free outflow of foam released during an attack.
To fix the tongue in order to avoid its falling into the pharyngeal cavity.
In the intervals between attacks, remove vomit and foam from the mouth.

It is possible to stop a repeated series of seizures with the help of intravenous administration of magnesia (20 ml of a 25% solution for 30 minutes).

It is important to remember that in an emergency, you can call 03 and ask the doctor on duty to give you instructions on what to do while the ambulance is on the way.

Treatment of eclampsia in pregnancy

Therapy for severe gestosis consists of two stages. First you need to stop the convulsions, and then - to lower blood pressure. At the same time, it is necessary to eliminate edema in order to alleviate the condition of the woman.

However, this is only an auxiliary measure in the treatment of eclampsia. The main actions should be the normalization of pressure and anticonvulsant therapy. It is important to follow a certain sequence in the appointment of treatment.

So, reducing pressure without eliminating seizures will not give the expected effect and will generally be difficult, since the pregnant woman will not be able to take pills or medicine due to the high muscle tone that occurs during convulsive seizures.

Anticonvulsant therapy

All medicines intended for the relief of seizures can be divided into three categories:

Preparations intended for emergency exposure: 25% magnesium solution, Droperidol, Diazepam.
Preparations intended for maintenance therapy: 25% magnesium solution at a dosage of 2 g per hour, Fulsed, Seduxen, Andaksin.
Drugs that enhance the sedative effect: Diphenhydramine, Glycine.

Dosage must be prescribed by a doctor. All anticonvulsants tend to noticeably relax the muscles and cause excessive drowsiness. If the attacks of eclampsia were stopped and delivery did not take place, then the therapy should be repeated throughout the entire period of pregnancy in order to avoid new manifestations of preeclampsia.

Antihypertensive therapy

It is carried out after the relief of seizures. It is important not only to reduce high blood pressure once, but also to keep it within normal limits - this can be difficult if, with eclampsia, it was decided not to do an emergency delivery.

Preparations intended for emergency exposure: Nifediline, Sodium nitroprusside (intravenously, maximum - 5 mcg per 1 kg of body weight per minute.)
Drugs intended for maintenance therapy: Methyldopa.

Medicines for high blood pressure should be taken until the end of pregnancy so that attacks do not recur. Antihypertensive therapy should be carried out in the first place only if the patient has a threat of cerebral hemorrhage.

In severe cases of eclampsia, delivery is indicated as a treatment, regardless of the gestational age and the condition of the fetus. In this case, the life of the mother is at stake, so all possible measures must be taken to save her. However, when organizing childbirth, the following conditions must be met:

Seizures must be stopped. It is necessary to start delivery procedures only a few hours after the attack stops.
If possible, childbirth should be done through natural routes. Cesarean section involves general anesthesia, which can provoke a new wave of seizures after recovery from anesthesia.
Generic activity must be stimulated artificially. It is important to meet the period when the attack has receded - when it resumes, the muscles of the whole body will again come into tone and the birth of a child will become difficult.

Prevention

Preventive measures to prevent eclampsia are prescribed either to those patients who had this condition in history, during previous pregnancies, or to those who have already had seizures and there is a need to prevent new ones.

The gynecologist may prescribe calcium supplements or aspirin. Depending on the condition of the woman and the fetus, these drugs are prescribed for the entire period, or for a certain period of time, until the doctor is convinced that the patient is out of danger.

The treatment of eclampsia in a pregnant woman requires the immediate intervention of a specialist, so all the actions of her relatives should be limited to providing first aid until the arrival of the medical team.

Eclampsia is a disease that occurs in pregnant women, in which blood pressure rises so much that there is a threat to the health of the child and mother. Usually, eclampsia in pregnant women occurs in the third trimester or within 24 hours after childbirth.

Most often, eclampsia during pregnancy and postpartum eclampsia occurs in nulliparous young girls and nulliparous women over 40 years of age.

Eclampsia in pregnancy occurs in women with acute kidney disease. Renal eclampsia is seen in nephropathy, acute nephritis, and rarely in chronic nephritis.

The main cause of the disease is an increase in blood pressure, in which a spasm of cerebral vessels occurs. Spasms lead to disruption of the blood supply to the brain and its edema.

Risk factors

Eclampsia during pregnancy and postpartum eclampsia can develop under the influence of the following factors:

eclampsia in the mother;
eclampsia in previous pregnancies from one partner;
young age;
first birth;
multiple pregnancy;
systemic lupus erythematosus;
kidney disease

Symptoms of eclampsia

Renal eclampsia in pregnant women is accompanied by a seizure. Convulsions develop in a certain sequence: first, the muscles of the face begin to contract, then the upper limbs undergo contraction. After that, convulsions cover all the muscles of the skeletal muscles. Breathing is impaired or completely absent. The patient loses consciousness, the pupils dilate.

Convulsive symptoms of eclampsia may be accompanied by foam from the mouth, often with blood. The patient may bite her tongue. After convulsions, the pregnant woman falls into an eclamptic coma.

Before an attack, the patient feels a headache, general weakness, dizziness, vision is impaired, pain occurs in the right hypochondrium and epigastric region.

There are diseases of a specific nature associated with pressure, and these include eclampsia during pregnancy.

It can manifest itself only in women, and often in the third trimester of an “interesting situation”, but not as an independent disease, but as a result of other factors.

What is eclampsia in pregnancy

The article will talk about eclampsia in pregnancy, what it is and how it manifests itself. There are different opinions about this disease even in scientific medical circles. Thus, the World Health Association classifies eclampsia as one of the syndromes of stable hypertension. In Russia, doctors have a different point of view, believing that this disease during pregnancy is nothing more than a consequence of preeclampsia.

In other words, eclampsia is the highest degree of development of late toxicosis of pregnant women. Not every organism normally adapts to the process of bearing a child, but women suffering from toxicosis, there are about 30% of the total mass.

Attention! A complicated pregnancy in a woman indicates that some systems in the body failed or already had a pathology at the time of conception.

A pregnant woman with pressure should be constantly under the supervision of the attending physician - this will help prevent the development of eclampsia, because before it begins, gestosis will need to go through other stages:

it all starts with edema;
further nephropathy of 3 degrees is observed;
then preeclampsia appears;
and eclampsia, as the peak of toxicosis.

Foreign doctors take high blood pressure as a basis, which a woman may suffer even before pregnancy. During the “interesting position”, hypertension is more likely a consequence of a malfunction in the kidneys, which is why puffiness develops. The pregnant woman is then diagnosed with albuminuria because protein is found in the urine. Increased blood pressure against the background of these 2 signs allows doctors to make another 1 diagnosis - “nephropathy”.

If proper treatment is not taken, then eclampsia in a pregnant woman will become more severe and toxicosis passes to the stage of preeclampsia. A pregnant woman has pain in the head and pancreas, sometimes this is accompanied by vomiting. The woman begins to suffer from insomnia, she has a depressed mood and problems with vision (flies, a veil before her eyes, etc.).

Already at this stage, preterm labor can begin, which occurs in a woman with complications. If preeclampsia has reached its peak, then eclampsia will not easily add difficulties to the delivery process - this is a dangerous situation for both the life of the child and his mother.

Causes of eclampsia in a pregnant woman

The last phase of late toxicosis is a consequence of an inattentive attitude to previous symptoms. The first stages (dropsy, hypertension, nephropathy, preeclampsia) can already be called the causes of the development of the problem under consideration. Therefore, trying to determine the causes that led to a serious problem, you need to study the clinic from the first stages.

Although until now, scientists cannot accurately determine the factors that cause convulsive conditions. The main one is pregnancy, which led to the failure of some organs (in particular, kidney pathology). Among other causes of eclampsia during pregnancy, the following can be distinguished:

heredity;
pathology of the child's place;
problems with the heart and blood supply;
disturbances in the structure of the brain;
multiple pregnancy.

If the family has already had cases of eclampsia, then a woman needs to prepare for something similar in her pregnancy - here the genetic predisposition of the problem can be traced. But it is not necessary that a convulsive seizure overtake a pregnant woman. For this to happen, other factors must come into play.

It happens that the placenta is not properly attached to the wall of the uterus, causing the fetus to receive less nutrition and oxygen. The child's place begins to correct this situation, stimulating accelerated blood circulation, which appears against the backdrop of high pressure. This is most often observed in women with multiple pregnancies.

Due to the pathology of the kidneys, the organs do not cope well with their duties, and the blood becomes clogged with urine derivatives. There is a failure in metabolic processes, and protein begins to be excreted in the urine. All this affects both blood circulation and pressure surges, and is also the cause of severe toxicosis.

Pathologies in the structure of the brain can develop even before pregnancy due to trauma. But slagging of blood vessels and hypertensive crises also cause modifications. Brain dysfunction is one of the factors in the development of eclampsia.

The body approaches eclampsia gradually, and the signs of the previous stages have already been mentioned above. Seizures are the main symptom of eclampsia. But they are preceded by other signs:

increased headache;
jump in blood pressure;
deterioration of vision.

As soon as signs of eclampsia appear, a woman may notice muscle twitching on her face, drooping of the corners of her lips. The eyelids are closed, but the whites of the eyes are slightly visible. The muscles of the whole body immediately begin to contract. The body is tense, breathing is slow (or completely stopped), the face is blue.

Muscle twitching on the face, limbs and other parts of the body is observed for some time, then the convulsions weaken and the hoarse breathing of the pregnant woman is heard. A similar seizure in eclampsia usually lasts no more than 2 minutes. After that, consciousness gradually begins to return, but a woman can immediately be overtaken by another wave of convulsions (in some cases, more than 10 were observed).

Important! During attacks of eclampsia, a woman can bite her tongue or choke on vomit, which sometimes manifests itself in this state. If a pregnant woman is not picked up during convulsions, she falls and receives serious injuries that can harm not only her, but also the unborn baby.

Diagnosis of eclampsia during pregnancy

By itself, eclampsia does not need to be diagnosed - rapid convulsive seizures are already a confirmation of the disease. But in order to prevent this stage of toxicosis, the precursors should be diagnosed - dropsy, hypertension, kidney pathology, which lead to preeclampsia.

The principles of diagnosing this problem include the following steps:

study of complaints corresponding to late toxicosis;
collection of anamnestic data;
conducting laboratory tests of blood and urine;
tracking pressure dynamics;
performing an ultrasound examination.

When the first signs of toxicosis appear, the pregnant woman should tell the observing gynecologist about the symptoms. Any of the signs of toxicosis is already an indicator that there is a risk of developing eclampsia. Therefore, do not ignore headaches, pressure surges, drowsiness, irritability, nausea, and even skin itching.

Each pregnant woman, having become registered, must be examined by specialists to identify non-gynecological diseases. The health problems that a woman had before pregnancy are also taken into account. Diseases of the endocrine system, pathologies of the kidneys and heart, problems with blood and blood vessels - this is an incomplete list of diseases that can be harbingers of eclampsia.

Periodically handed over blood tests will help to notice in time the moment when it begins to thicken. Elevated hemoglobin, low platelet count already indicate the development of preeclampsia in a pregnant woman. In addition to a general blood test, a woman will also be prescribed a detailed biochemical (from a vein) - the onset of eclampsia can also be recognized by the level of bilirubin, urea, nitrogen. Daily urine tests will help determine the presence (or absence) of protein in the fluid.

Constant monitoring of blood pressure will make it possible to lower it in time. A sign of late toxicosis are indicators above 140/90, which last for at least 6 hours in a woman. The more severe the stage of preeclampsia, the higher the pressure rises, which in itself can provoke convulsions.

The pathology of the placenta can be determined using ultrasound, which will show how correctly the adhesion of the child's place to the wall of the uterus has occurred. By supplementing this study with dopplerography and cartiotocography, the doctor will be able to determine how susceptible the fetus is to hypoxia.

Treatment of eclampsia

It is desirable to start treatment of eclampsia in the first stages of toxicosis. But if the moment was missed and the woman had the prerequisites for the last stage of preeclampsia, she must be hospitalized and placed in a separate room. Isolation from bright light and loud sounds is necessary - any kind of irritant can provoke a convulsive attack and repeated toxicosis.

Treatment of eclampsia in pregnant women includes the following points:

pressure normalization;
strengthening the walls of blood vessels;
improvement of blood properties - normalization of coagulability, viscosity;
adjustment of brain activity;
the establishment of metabolic processes.

Therapy for a pregnant woman with eclampsia is only complex, so a woman will be simultaneously injected with various drugs - to reduce pressure, maintain heart activity, detoxify, etc. It is important to make forced diuresis in time to normalize kidney function.

Eclampsia can manifest itself at a time when the body is not yet ready for delivery (before the 34th week), so hormone therapy is prescribed to accelerate the maturation of the baby's lungs. If a miscarriage did not occur due to bouts of miscarriage, then the doctor himself must speed up the approach of childbirth, doing it quickly, but carefully, in order to save the life of both mother and child.

Emergency care for eclampsia in pregnant women

If a woman’s seizure began in the hospital, doctors will provide first aid for eclampsia, taking all necessary safety measures for the pregnant woman. But when this happens outside a medical facility, there will not always be a person nearby who can provide emergency care. Therefore, next to a woman who has signs of late toxicosis, someone should always be.

To provide a pregnant woman with the necessary assistance, there are methods, the algorithm of which is given below:

the woman is laid on her left side;
a solid object (for example, a spoon) is inserted between the teeth;
after convulsions, the woman's nasal cavity and mouth are cleaned of saliva, vomit, and blood.

Important! The pregnant woman should be laid on her left side so that she does not choke on her own vomit and saliva. The mouth expander will not allow a woman to bite her tongue and suffocate. If it is possible to give the patient oxygen while inhaling, then this should definitely be used.

Emergency care for eclampsia includes the introduction of magnesium sulfate - this will help prevent subsequent attacks. If the convulsions recur, the woman is given additional diazepam in several visits. After that, the patient is urgently sent to the intensive care unit.

Complications and consequences of the disease

Due to attacks of eclampia, anuria develops - the excretion of urine from the body stops, which can have serious consequences. Some patients have eclamptic pneumonia, aspiration and heart failure. Sometimes vision disappears, which usually recovers a week after the attacks.

Important! One of the consequences of eclampsia in women can be complete blindness due to retinal detachment. Sometimes pregnant women are overtaken by a stroke or paralysis breaks. Or they die (even with the first wave of convulsions) due to asphyxia, pulmonary edema, cardiac arrest or cerebral hemorrhage.

If the pregnant woman can be saved, then the convulsive seizures after the birth of the baby stop. But in some cases, postpartum eclampsia is observed in women - it all depends on the individual characteristics of the body and related factors. Against the background of eclampsia, some women develop psychosis, which can last for several months and be aggravated by postpartum depression.

Prevention of eclampsia in women

You can avoid eclampsia for a woman if you pay attention to the first signs of late toxicosis and immediately take the necessary measures. As a preventive measure for eclampsia, pregnant doctors suggest the following:

selection of food according to the recommendations of the physician;

taking vitamin and mineral complexes for pregnant women;

from the beginning of the 20th week, take small doses of aspirin to thin the blood;

throughout pregnancy to drink calcium supplements.

The systematic observation of a pregnant woman by a doctor and the fulfillment of all his prescriptions will help to avoid severe toxicosis, which a woman should get rid of even at the stage of the appearance of the first edema.