In severe preeclampsia, the CNS becomes irritated as a result of vasospasm and decreased organ perfusion. This causes a cortical brain spasm that results in headaches, hyperreflexia, seizure activity and the progression to eclampsia.
Due to CNS irritability and cortical brain spasm, the pregnant woman’s reflexes become hyper-exaggerated, signifying the possible development of eclampsia.
Due to the cortical brain spasm, the ankle may display rapid muscular contraction and relaxation appearing as a rhythmic tremor.
As hypertension progresses without proper management, the pregnant woman may experience severe headaches significant of increased pressures within the vessels of the brain.
Visual disturbances may occur as a result of retinal arteriolar spasm that develops due to progression of hypertension and vasospasm that occurs in severe preeclampsia.
Epigastric or right upper quadrant (RUQ) pain is usually an ominous sign and the woman frequently complains of this pain immediately before the onset of the seizure. In many cases, this pain/feeling is a harbinger of impending seizure. This could also represent worsening hepatopathy from pre-eclampsia.
Due to cortical brain spasm and increased CNS irritability, seizures can occur in the pregnant woman. These seizures can occur before birth, during birth, or after birth and are significant to eclampsia. Typical seizure care includes airway management, administration of oxygen, turning the patient on their side, and padding side rails.
Due to severely increased CNS irritability, the patient can progress to a comatose state. This is a severe complication of eclampsia.
It is imperative in this obstetric emergency to call for help and not leave the patient alone.
This medication is given to control seizures in the woman with eclampsia. Calcium gluconate should be available to reverse any effects of magnesium toxicity (depressed DTRs, bradypnea, oliguria), as the woman has more than likely been receiving magnesium sulfate prior to the onset of seizure activity. It is crucial to monitor for respiratory depression.
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