Pre-eclampsia and Eclampsia Overview

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Questions and Answers

What is the recommended response for a woman experiencing eclamptic seizures?

Transport to the nearest pharmacy

Monitor for an hour and call a midwife

Administer IV access and drugs if paramedic is on scene (correct)

Wait for further instructions from the mother

Maternal sepsis can only be caused by direct pregnancy-related issues.

False

What does NEWS2 stand for in the context of managing suspected sepsis?

National Early Warning Score 2

A pre-alert should be made to the nearest _________ unit when suspected sepsis is identified.

obstetric Signup and view all the answers

What constitutes a critical condition requiring immediate attention?

One red flag or two amber flags Signup and view all the answers

Match the following causes of maternal sepsis with their description:

Direct cause = Pregnancy or genital tract related Indirect cause = Caused by conditions like influenza or COVID-19 Increased susceptibility = Reduced immunity in pregnancy Rapid onset = Quick development of symptoms Signup and view all the answers

When should antibiotics be administered to a patient with suspected sepsis?

Within an hour of sepsis onset Signup and view all the answers

It is important to call a midwife in the presence of red flags to ensure proper care.

False Signup and view all the answers

What defines pre-eclampsia?

Hypertension with proteinuria after 20 weeks gestation Signup and view all the answers

Eclampsia is defined as having new onset convulsions during pregnancy without a history of pre-eclampsia.

False Signup and view all the answers

What does the presence of proteinuria indicate in a pregnant woman?

Organ dysfunction Signup and view all the answers

Individuals with a body mass index of ______ or more are at higher risk for pre-eclampsia.

35 Signup and view all the answers

Match the pregnancy complications with their definitions.

Pre-eclampsia = New hypertension with proteinuria after 20 weeks Eclampsia = Convulsions during pregnancy generally with pre-eclampsia Sepsis = Severe infection that can occur during or after childbirth Signup and view all the answers

Which of the following is NOT a risk factor for pre-eclampsia?

Having a body mass index of less than 20 Signup and view all the answers

It is safe to ignore signs of severe pre-eclampsia until the patient has a seizure.

False Signup and view all the answers

What position should a patient with pre-eclampsia be in during conveyance?

Right or left lateral position Signup and view all the answers

Study Notes

Pre-eclampsia

Defined as new hypertension (blood pressure >140/90 mmHg) with proteinuria occurring after 20 weeks of gestation.
Proteinuria indicates organ dysfunction, signalling potential complications.
Risk factors include:
- First pregnancy
- Age 40 or older
- More than 10 years between pregnancies
- Body mass index (BMI) of 35 or more
- Family history of pre-eclampsia or occurrence in prior pregnancies
- Multiple pregnancies
- Existing medical conditions (hypertension, renal or cardiac disease, diabetes).
Management requires thorough assessment using the ABCDE approach, with a focus on identifying time-critical features.
Continuous monitoring of blood pressure and left or right lateral positioning are essential during transport.
Severe pre-eclampsia poses life-threatening risks such as stroke and sub-arachnoid hemorrhage.

Eclampsia

Characterized by new-onset convulsions during pregnancy or postpartum, typically in women with pre-eclampsia.
Convulsions present as tonic/clonic seizures and are usually short-lived.
Treatment includes ensuring intravenous access and administering appropriate medications if paramedics are present during seizures.

Maternal Sepsis

Ante-partum and post-partum sepsis is a leading cause of maternal mortality in the UK.
Can arise directly from pregnancy-related issues or indirectly due to conditions like influenza, COVID-19, or streptococcal infections.
Pregnant women experience reduced immunity, increasing susceptibility to infections, and can present with rapid-onset sepsis.

Management of Suspected Sepsis

NEWS2 (National Early Warning Score) is not validated for pregnant patients; use the Maternity Assessment Card to identify critical red flags.
Immediate pre-alert to the nearest obstetric unit is crucial, and antibiotics should be administered within one hour of sepsis onset.
One red flag or two amber flags indicate urgent action:
- If 20 weeks or more gestation and stable, convey to maternity unit.
- If less than 20 weeks gestation or unstable, convey to Emergency Department with obstetric support.
Avoid calling a midwife in the presence of red flags to prevent delays in care.

Summary

Close monitoring and continuous assessment are vital for suspected pre-eclampsia until handover at the hospital.
Utilize the maternal assessment card for guiding assessments in pregnancy complications.
Request additional resources promptly but avoid scene delays.
Document all cases of pregnancy complications in Datix for record-keeping and accountability.

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Description

This quiz covers the definitions, risk factors, and management strategies for pre-eclampsia and eclampsia. It highlights the importance of monitoring and the potential complications associated with these conditions during pregnancy. Test your knowledge on critical features and care approaches in maternal health.