Management of eclampsia

A. Maintenance of airway patency and prevention of aspiration are the initial management priorities. The patient should be rolled onto her left side and a padded tongue blade placed in her mouth, if possible.

B. Control of convulsions. Magnesium sulfate, 2 to 4 g IV push repeated every 15 minutes to a maximum of 6 g. Maintenance dose of magnesium sulfate: 2 to 3 g/hour by continuous intravenous infusion. Diazepam may also be given as 5 mg IV push repeated as needed to a maximum cumulative dose of 20 mg to stop the convulsions; however, benzodiazepines have profound depressant effects on the fetus.

C. Postpartum course. Hypertension due to preeclampsia resolves postpartum, often within a few days, but sometimes taking a few weeks. Severe hypertension should be treated; antihypertensive medications can be discontinued when blood pressure returns to normal.

III. Postpartum hypertension. A small rise in blood pressure is common, with an average increase in systolic and diastolic pressure of 6 and 4 mm Hg, respectively, in the first four postpartum days.

A. Preeclampsia-related hypertension usually resolves within a few weeks (average 16 days) and should always be gone by 12 weeks postpartum. Mild hypertension that persists beyond this period should be evaluated and treated.

B. Angiotensin converting enzyme (ACE) inhibitors, beta-blockers, and calcium channel blockers are suitable choices for nonbreastfeeding mothers. ACE inhibitors should be avoided during lactation. Diuretics may reduce milk volume and should be avoided.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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