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Acute Management of The Obstretic Patient With
Acute Management of The Obstretic Patient With
2.Nifedipine--orally
---oral nifedipine of 10mg start dose
is used esp in postpartum women
with acute hypertensive crisis
---sublingual nifedipine is not
recommended
3.Hydralazine(Apresoline)
---another alternative
---IV injection(IV 5mg stat,then 510mg every 20-30 minutes are
required)
---IV injection given as slow boluses
over one minutes
Impending/Imminent Eclampsia
Use of anti-hypertensive agents and
anti-convulsant agents as prevention
of eclampsia
Anti hypertensive agents is initiated
if diastolic BP is presistently 100
mmHg
Eclampsia
Use of anti hypertensive agents and anti convulsant agents to
abort eclamptic fit
MANAGEMENT
1.RED ALERT
2.Place the patient in left lateral position(recovery position)
3.Secure airway-patent
Breathing-8L/min oxygen
Circulation-2 large bre IV lines
4.Send blood for investigation : FBC,GXM,coagulation profile,renal
profile,liver function test
5.Admit to HDU
-fluid management
-antihypertensive therapy
-MgSO4(loading and maintanence) as in protocol
5.Monitoring in
-- I/O chart
--PE chart-BP monitoring
--Fit chart-toxicity
--Fetal movement chart
6.Plan:time and mode of delivery once stable
and adequate analgesia ,call pediatrician
7.Monitoring in HDU for next 24-48 hours
---MgSo4,antihypertensive,fluid replacement
---Active management after delivery