The majority of pregnancies don't need the ED, but sometimes things don't go to plan, therefore a working knowledge of physiology in pregnancy and certain presentations are common MCEM questions.
For Part A
For Part B
Pre-Eclampsia affects around 5-6% of pregnancies. It is a triad of...
- Hypertension
- Proteinuria
- Oedema
1-2% of patients with pre-eclampsia will develop eclampsia. Eclampsia is marked by the development of seizures.
For Pre-eclampsia:
- Obstetric input
- Consider left lateral position - see physiological changes in pregnancy
- Control BP - labetalol/ hydralazine
- Limit fluid input.
- Consider magnesium
- Delivery is the definitive management. Notably pre-eclampsia can develop for up to several weeks after delivery!
For Eclampsia:
- ABC!
- Magnesium 4g IV over 5-10 mins to treat seizures.
Further Reading:
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