Eclampsia

Key points

• Eclampsia = development of seizures in association with pre-eclampsia (condition seen after 20 weeks gestation: pregnancy-induced hypertension + proteinuria)
• Magnesium sulphate is used both to prevent seizures in severe pre-eclampsia and to treat seizures once they develop (first-line in eclampsia); give once a decision to deliver has been made
• In eclampsia: IV bolus of 4 g over 5-10 minutes, followed by an infusion of 1 g/hour
• Monitor urine output, reflexes, respiratory rate and oxygen saturations; continue treatment for 24 hours after the last seizure or delivery (around 40% of seizures occur post-partum)
• Restrict fluids to avoid fluid overload — pulmonary and cerebral oedema are important causes of morbidity and mortality in severe pre-eclampsia; giving IV fluids to prevent renal failure is incorrect

Decision points in this pathway

• Seizures in association with pre-eclampsia (eclampsia)?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.