Obstetric Emergencies: Eclampsia Overview

Obstetric Emergencies

• Obstetric emergencies encompass a wide range of critical situations arising during pregnancy, childbirth, or the postpartum period, requiring immediate intervention to preserve maternal and fetal well-being.
• Timely recognition and appropriate management are crucial for positive outcomes.

Eclampsia

• Eclampsia is a severe complication of pre-eclampsia, characterized by the sudden onset of seizures in a pregnant or postpartum woman.
• It is a life-threatening condition requiring immediate medical attention.
• Risk Factors: Pre-eclampsia, maternal age above 40 or below 20, multiple pregnancies, pre-existing hypertension, diabetes, kidney disease, and obesity.
• Symptoms: Hypertension, proteinuria, edema, headaches, blurry vision, severe epigastric pain, and the occurrence of tonic-clonic seizures.
• Diagnosis: Clinical evaluation, blood pressure monitoring, urine analysis, and potentially electroencephalogram (EEG) assessment.
• Treatment: Magnesium sulfate is considered the first-line treatment to prevent further seizures. Intravenous antihypertensive medications are used to control blood pressure. Medication to control seizure activity is also required. Maintaining a stable airway and providing supportive care are essential.

Sepsis in Obstetrics

• Sepsis in obstetrics is an advanced condition characterized by a life-threatening dysregulated host response to infection.
• It can occur during pregnancy, childbirth, or the postpartum period.
• Risk Factors: Cesarean section, prolonged rupture of membranes, chorioamnionitis, postpartum hemorrhage, etc.
• Symptoms: Maternal fever, rapid heart rate (tachycardia), rapid breathing (tachypnea), low blood pressure (hypotension), and altered mental status.
• Diagnosis: History taking, physical exam for signs of infection, assessing vitals (body temperature, heart rate, blood pressure, respiratory rate, and oxygen saturation). Blood tests, including complete blood count (CBC), blood cultures, and inflammatory markers (like procalcitonin and C-reactive protein), are vital to confirm the infection and severity.
• Treatment: Prompt administration of broad-spectrum antibiotics is crucial. Maintaining adequate fluid balance, and managing any organ dysfunction are also key aspects. Close monitoring of hemodynamic stability, oxygenation, and kidney function is critical. Supportive care, including intensive care unit (ICU) support, may be necessary.