Emergency management of eclampsia and severe pre-eclampsia.
Eclampsia and severe pre-eclampsia are rare, but potentially life-threatening conditions that emergency physicians must be able to diagnose and treat promptly, because initial presentations to the ED are real possibilities. The treatment of the major complications of this disorder, hypertension and seizures, have been the focus of much research. Magnesium sulphate is now the first line agent for acute treatment and prophylaxis of seizures in eclampsia and pre-eclampsia. Severe pre-eclampsia should be treated with magnesium to prevent progression to eclampsia. Severe hypertension requires treatment with an intravenous antihypertensive agent familiar to the clinician. No single antihypertensive has been proven to be better than another, although in Australia, hydralazine is probably the initial intravenous agent of choice. Routine use of invasive haemodynamic monitoring and volume expansion is not recommended and consultation with obstetric colleagues is essential.
Lew
Martin
M
Maroondah Hospital, Emergency Department, Mt Dandenong Road, East Ringwood 3135, Vic., Australia. martinchrista@optusnet.com.au
Klonis
Evangelos
E
D000959:Antihypertensive Agents / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory; D004461:Eclampsia / Q000175:diagnosis / Q000628:therapy*; D004638:Emergency Treatment; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy
D000959:Antihypertensive Agents; D008274:Magnesium