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Eclamptic Seizure Management

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1. Eclamptic Seizure Management

Eclamptic Seizure Management Eclamptic Seizure Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Eclamptic Seizure Management (...) Eclamptic Seizure Management Aka: Eclamptic Seizure Management , PIH Seizure Prophylaxis , PIH Seizure Management II. Management: Seizure Prophylaxis See offers best PIH prevention Reference III. Management: Seizure Anticonvulsant Medications (if not already started) Loading dose: 4-6 grams IV over 15-20 minutes Maintenance: 2 grams per hour Consider rebolus of 2 grams if recurs (do not exceed >8 g bolus between prior bolus and rebolus) Obtain level at 4 hours Anticonvulsant not recommended routinely

2018 FP Notebook

2. Prodromal symptoms, health care seeking in response to symptoms and associated factors in eclamptic patients. (PubMed)

Prodromal symptoms, health care seeking in response to symptoms and associated factors in eclamptic patients. Eclampsia is one of the leading causes of maternal death worldwide. Maternal catastrophe is made worse in developing countries by the high incidence coupled with delayed presentation of patients and health facility constraints in effective management of eclampsia and its complications.A prospective study of all 93 eclamptic women admitted to a general hospital in Somali regional state (...) , Ethiopia was conducted between May 1, 2014 and April 30, 2015 using a structured questionnaire which included socio-demographic data, antenatal visit status, distance of nearest maternal health facility, timing of convulsions, questions related to symptoms preceding seizures; health care seeking for the symptoms and time interval from prodromal symptoms to the diagnosis of eclampsia. Descriptive statistics and multivariable logistic regression analyses were conducted. Statistical tests were done

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2017 BMC Pregnancy and Childbirth

3. Eclamptic Seizure Management

Eclamptic Seizure Management Eclamptic Seizure Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Eclamptic Seizure Management (...) Eclamptic Seizure Management Aka: Eclamptic Seizure Management , PIH Seizure Prophylaxis , PIH Seizure Management II. Management: Seizure Prophylaxis See offers best PIH prevention Reference III. Management: Seizure Anticonvulsant Medications (if not already started) Loading dose: 4-6 grams IV over 15-20 minutes Maintenance: 2 grams per hour Consider rebolus of 2 grams if recurs (do not exceed >8 g bolus between prior bolus and rebolus) Obtain level at 4 hours Anticonvulsant not recommended routinely

2015 FP Notebook

4. Recurrent Seizures in 2 Patients with Magnesium Sulfate-Treated Eclampsia at a Secondary Hospital (PubMed)

Recurrent Seizures in 2 Patients with Magnesium Sulfate-Treated Eclampsia at a Secondary Hospital BACKGROUND Recurrent seizure in patients with magnesium sulfate-treated eclampsia is very rare and requires meticulous management due to poor prognosis. The development of eclamptic convulsions is considered a preventable obstetric situation. Magnesium sulfate has been the drug of choice in such cases. However, some cases are persistent and need more aggressive treatment. CASE REPORT First case (...) and the seizures remained controlled. Both babies were delivered without any significant complications. CONCLUSIONS We report 2 cases of GIP0-0 women with 40 weeks GA who had magnesium sulfate-resistant eclampsia and needed additional anticonvulsant drugs. These cases show the importance of comprehensive management and the need for alternative drugs in eclampsia.

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2018 The American journal of case reports

5. Low-dose magnesium sulphate in the control of eclamptic fits: a randomized controlled trial. (PubMed)

Low-dose magnesium sulphate in the control of eclamptic fits: a randomized controlled trial. Magnesium sulphate is now the gold standard for the control of eclamptic fits. The place of low-dose magnesium sulphate for the control of eclamptic seizures is yet to be determined.To determine the effectiveness of low-dose magnesium sulphate in controlling eclamptic fits.Randomized controlled trial comparing low-dose with standardized dosing regimen.Labour Unit of the department of Obstetrics (...) also no differences in both foetal and maternal outcomes in the two study groups.The effectiveness of low-dose regimen of magnesium sulphate appeared comparable to the 'standard dose regimen'. Low-dose regimen may guarantee more safety and in an environment (such as ours) where cost is an important determinant of accessibility to qualitative health services, it is certainly attractive. More studies are needed to establish the place of low-dose regimen of magnesium sulphate in the management

2013 Archives of gynecology and obstetrics

6. Hypertension in pregnancy: diagnosis and management

hypertension whose hypertension has not responded to initial treatment. 1.8 Medical management of severe hypertension or severe pre-eclampsia in a critical care setting 1.8.1 1.8.1 Anticon Anticonvulsants vulsants 1.8.1.1 If a woman in a critical care setting who has severe hypertension or severe pre- eclampsia has or previously had an eclamptic fit, give intravenous magnesium sulphate* . 1.8.1.2 Consider giving intravenous magnesium sulphate* to women with severe pre- eclampsia who are in a critical care (...) Hypertension in pregnancy: diagnosis and management Hypertension in pregnancy: diagnosis Hypertension in pregnancy: diagnosis and management and management Clinical guideline Published: 25 August 2010 nice.org.uk/guidance/cg107 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

7. Management of Hypertension (4th Edition)

Management of Hypertension (4th Edition) Ministry of Health Malaysia Academy of Medicine of Malaysia Malaysian Society of Hypertension Management of Hypertension (4 th Edition) CLINICAL PRACTICE GUIDELINES MOH/P/PAK/272.13(GU) ISBN 978-967-12406-0-1STATEMENT OF INTENT This guideline was developed to be a guide for best clinical practice in the management of hypertension. All efforts were made to ensure references quoted were the most current at the time of printing. Specific attempts were made (...) to use local data and publications to ensure local relevance. Adherence to this guideline may not necessarily lead to the best clinical outcome in individual patient care. Every health care provider is responsible for the care of his/her unique patient based on the clinical presentation and treatment options available locally. However adherence to this guideline is strongly recommended as a starting point in managing patients as it constitute the best available evidence at the time of writing. REVIEW

2013 Ministry of Health, Malaysia

8. Seizures in the Emergency Department (Overview)

as being in (SE). Newer definitions suggest that SE is defined by duration of 5 continuous minutes of generalized seizure activity or 2 or more separate seizure episodes without return to baseline. [ ] This article focuses on the emergency department (ED) evaluation, management, and disposition of adult patients presenting for evaluation of seizure. in children are a distinct entity and are discussed in a separate article. Next: Pathophysiology A seizure results when abnormal neuronal firing manifests (...) in the ED include the following: Trauma (ICH) Alcohol withdrawal or medication withdrawal Drug-induced seizures Seizures in pregnancy are a complication of severe, untreated preeclampsia. In fact, eclampsia can occur up to 4 weeks after delivery. [ ] Seizing pregnant patients should be treated just as nonpregnant patients are because the risk of complications from the seizure outweighs the risk of toxicity from the antiepileptics. Fortunately, eclamptic seizures are usually short in duration. Magnesium

2014 eMedicine.com

9. Guidelines for the management of hypertensive disorders of pregnancy 2008

. It should be remembered that eclampsia is not the commonest cause of seizures in pregnancy and the differential diagnosis includes epilepsy and other medical problems that must be considered carefully, particularly when typical features of severe preeclampsia are lacking. Management of eclampsia Comprehensive protocols for the management of eclampsia (and severe hypertension) should be available in all appropriate areas. There are four main aspects to care of the woman who sustains eclampsia. 1 (...) Guidelines for the management of hypertensive disorders of pregnancy 2008 GUIDELINES FOR THE MANAGEMENT OF HYPERTENSIVE DISORDERS OF PREGNANCY 2008CONTENTS 1. Definition of hypertension in pregnancy Page 3 2. Recording blood pressure in pregnancy Page 4 3. Classification of hypertensive disorders in pregnancy Page 4 4. Investigation of new onset hypertension in pregnancy Page 7 5. Management of preeclampsia and gestational hypertension Page 8 6. Fetal Surveillance Page 13 7. Resolution

2008 Clinical Practice Guidelines Portal

10. Epilepsy in Pregnancy

aspects of diagnosis are specific to pregnancy and the puerperium, including the definition of seizures for the obstetrician? The diagnosis of epilepsy and epileptiform seizures should be made by a medical practitioner with expertise in epilepsy, usually a neurologist. Women with a history of epilepsy who are not considered to have a high risk of unprovoked seizures can be managed as low-risk women in pregnancy. What is the importance of classifying seizure type and epilepsy syndrome? Women (...) with epilepsy (WWE), their families and healthcare professionals should be aware of the different types of epilepsy and their presentation to assess the specific risks to the mother and baby. What other conditions in pregnancy should be considered in the differential diagnosis of epileptic seizures? In pregnant women presenting with seizures in the second half of pregnancy which cannot be clearly attributed to epilepsy, immediate treatment should follow existing protocols for eclampsia management until

2016 Royal College of Obstetricians and Gynaecologists

11. Risk Analysis of Intensive Care Mangement on Maternal and Fetal Outcome of Severe Preeclampsia and Eclampsia

Risk Analysis of Intensive Care Mangement on Maternal and Fetal Outcome of Severe Preeclampsia and Eclampsia Risk Analysis of Intensive Care Mangement on Maternal and Fetal Outcome of Severe Preeclampsia and Eclampsia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (...) Update Posted : January 26, 2018 Sponsor: Cairo University Information provided by (Responsible Party): Ahmed Maged, Cairo University Study Details Study Description Go to Brief Summary: Laboratory monitoring of patients included serial measurement of complete blood cell count, liver function tests, coagulation profile, and renal function tests. ICU management during conduction of the research study included the following: Control of convulsions using magensium sulphate. Control of blood pressure

2018 Clinical Trials

12. China Obstetrics Alliance Cohort Study

: Preeclampsia (PE) is one of a common type of hypertensive disorder complicating pregnancy (HDCP). It is a class of clinical syndromes which shows relevant symptoms, hypertension and proteinuria after 20 weeks pregnant as main characteristic, and may accompany with fetal anomaly and systemic multi-system organs damage. Several complications, such as eclamptic seizures, coma, intracranial hemorrhage (ICH), cardiac failure, pneumonedema, hepatic failure, kidney failure, placental abruption and disseminated (...) China Obstetrics Alliance Cohort Study China Obstetrics Alliance Cohort Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. China Obstetrics Alliance Cohort Study The safety and scientific validity

2018 Clinical Trials

13. Detection of Epileptiform Activity in Severe Preeclampsia

the prophylactic magnesium treatment is mostly maintained throughout a period of several days before and after delivery of the fetus and placenta, as up today there is no reliable clinical or diagnostic approach to predict the risk of eclamptic seizures. The actual gold standard in high-risk maternities is to assess clinical symptoms as described above and perform newer laboratory essays, in order to estimate the parturient's risk for preeclamptic complications. Insofar changes in serum levels of fms-like (...) Detection of Epileptiform Activity in Severe Preeclampsia Detection of Epileptiform Activity in Severe Preeclampsia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Detection of Epileptiform Activity

2018 Clinical Trials

14. China Obstetrics Alliance Cohort Study

after 20 weeks pregnant as main characteristic, and may accompany with fetal anomaly and systemic multi-system organs damage. Several complications, such as eclamptic seizures, coma, intracranial hemorrhage (ICH), cardiac failure, pneumonedema, hepatic failure, kidney failure, placental abruption and disseminated intravascular coagulation (DIC), may be threat to the life of the mother as well as fetal. Thus, the disease is one of the core issues that cause the maternal and perinatal death. Morbidity (...) China Obstetrics Alliance Cohort Study China Obstetrics Alliance Cohort Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. China Obstetrics Alliance Cohort Study (COACS) The safety and scientific

2017 Clinical Trials

15. Efficacy and Safety of 1 g Vs 2 g Per Hour Intravenous Maintenance Dose of MgSO4 in Women With Severe Pre-eclampsia

of eclampsia and convulsions, and planning for delivery. Magnesium sulfate has been used to prevent eclamptic convulsion since 1925, its efficacy was confirmed by a large randomized controlled trial in 2002. Eclampsia could be prevented in more than 50% after magnesium sulfate administration . The World Health Organization recommended magnesium sulfate as the most effective, safe, and low-cost drug for the prevention of seizure in severe preeclampsia and eclampsia . The recommended dose of magnesium (...) Efficacy and Safety of 1 g Vs 2 g Per Hour Intravenous Maintenance Dose of MgSO4 in Women With Severe Pre-eclampsia Efficacy and Safety of 1 g Vs 2 g Per Hour Intravenous Maintenance Dose of MgSO4 in Women With Severe Pre-eclampsia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2017 Clinical Trials

16. Effect of Magnesium Sulphate Pre-exposure on Oxytocin-induced Contractility in Desensitized Human Myometrium

Effect of Magnesium Sulphate Pre-exposure on Oxytocin-induced Contractility in Desensitized Human Myometrium Effect of Magnesium Sulphate Pre-exposure on Oxytocin-induced Contractility in Desensitized Human Myometrium - an in Vitro Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum (...) to oxytocin occurs, leading to reduced contractions of the uterus with the same doses of oxytocin. This has been demonstrated in previous studies done by the investigators. The resultant need for a higher oxytocin dose to cause adequate uterine contraction has also been demonstrated in laboring women having received oxytocin for labor augmentation. Magnesium sulphate (MgSO4) is widely used within obstetric medicine. It is used for seizure prevention and treatment in preeclampsia and eclampsia, and is used

2016 Clinical Trials

17. Eclampsia

, Eclamptic Seizure II. Definitions Eclampsia ("sudden flash" or "shining forth") Most severe form of PIH characterized by s Also referred to as Toxemia or "toxin present" III. Epidemiology Rare <20 weeks gestation (except in hydatiform mole) Most episodes occur prior to delivery Antepartum : 53% of cases Intrapartum : 19% of cases Postpartum : 28% of cases Majority (79%) of postpartum s are late postpartum (>48 hours after delivery) IV. Pathophysiology Results from focal cerebral edema Associated (...) with transient striction and ischemia Usually results from progressive May also occur with little warning may precede Eclamptic Seizure is only mildly increased in 30-60% of patients Up to 15% of cases have diastolic BP <90 mmHg V. Signs See Phase 0: Preceding symptoms (80%) Visual changes (45%) Phase 1: Prodrome (brief) Twitching Facial congestion Mouth foaming Phase 2: Tonic Muscle rigidity Phase 3: activity for 1 to 1.5 minutes Rhythmic muscle contractions and relaxation Loss of respiratory activity Phase

2018 FP Notebook

18. Hypertensive Disorders of Pregnancy

Hypertensive Disorders of Pregnancy Hypertensive Disorders of Pregnancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hypertensive (...) ) See See See XIV. Management See See Management See See See See See See XV. Prevention See XVI. Complications: Maternal in Women See XVII. Complications: Fetus Neonatal Asphyxia XVIII. Course: Postpartum Observe postpartum for 72 hours inpatient or with close home monitoring PIH may have onset up to 6 weeks postpartum (even without antepartum PIH) Consider retained products of conception in postpartum differential diagnosis Most PIH cases improve in first 1-2 days after delivery decreases Diuresis

2018 FP Notebook

19. Hypertension in pregnancy

, and the likelihood of progression may be significantly greater among women with earlier presentation [ ]. A UK-wide obstetric survey reported that 7.5% of 214 women who developed eclamptic seizures had exhibited proteinuria without hypertension within 1 week of onset [ ]. In the absence of further guidance to inform management, CKS recommends seeking specialist advice if proteinuria persists, as specialist assessment and increased monitoring may be necessary. Seeking specialist advice in women with 2+ protein (...) with significant maternal morbidity. It can lead to eclamptic seizures, intracerebral haemorrhage, pulmonary oedema, acute renal failure, liver dysfunction, and coagulation abnormalities [ ]. Pre-eclampsia and eclampsia are among the most common causes of maternal death, with a rate of 8.5 per million pregnancies in the UK during 2003–2005 [ ]. Causes of death include intracranial haemorrhage, cerebral infarction, cerebral oedema, acute respiratory distress syndrome and pulmonary oedema, hepatic rupture

2015 NICE Clinical Knowledge Summaries

20. Neurobehavioural Outcomes in Late Preterm Neonates

Neurobehavioural Outcomes in Late Preterm Neonates Neurobehavioural Outcomes in Late Preterm Neonates - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Neurobehavioural Outcomes in Late Preterm Neonates (...) born to pre-eclamptic mothers had lower MDI scores at 24 months of age (P= 0.04) as compared to infants without maternal pre-eclampsia. The study by Szymonowicz et al showed that neonates born to pre-eclamptic mothers had a significantly lower mean mental developmental index, and significantly more of these children had one or more impairments compared with the control group at 2 years of age. The neurodevelopmental outcomes in neonates born to preeclamptic mothers therefore remain inconclusive

2015 Clinical Trials

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