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Preeclampsia case study ppt

04.01.2018 DANNIE L.

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Pre- eclampsia & eclampsia : a good court case presentation


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On testing

Tenderness throughout the girl right hypochondrium having nominal pedal edema

  • She seems to have Mallampati training 3 airway
  • Lab shows:

Platelets 100,000

AST 156

ALT 174

Creatinine 1

Introduction

  • Preeclampsia might be any condition by means of not known etiology.

    That may well always be due to excessive thromboxane around prostacycline through broad disperse vasoconstriction, flesh hypoxia & endothelial problems.

    Preeclampsia: Conditions, Disadvantages, Treatment in addition to Prevention

  • Right hypochondrial suffering might possibly be legitimate towards sub-capsular hematoma of all the ailing liver & her split carries 80% death cost

It is definitely a good lawsuit for acute pre-eclampsia by means of HELLP syndrome (Hemolysis, increased poorly liver digestive support enzymes & affordable platelet count)

  • Take caution the fact that eclampsia “seizures” will probably appear earlier than, all through or perhaps soon after offering
  • The mainly fix for pre-eclampsia/eclampsia is actually any sending with any baby & placenta

Pre-operative organization

  • Establish & continue to keep the particular neck muscles & provide O2 supplement.
  • Pulse Oximetry, ECG & circulation difficulty will need to become watched .
  • Expand your girlfriend 4 level by means of 500 ml liquid (crystalloids) with satisfactory UOP following & liquid stability chart.
  • Aspiration prophylaxis because H2 blocker & not particulate antacid.
  • Magnesium sulfate prophylaxis by simply repowering & maintenance doses.

Arterial lines meant for obtrusive circulation tension following during considerable pre-eclampsia preceding to help you neuroaxial blockade and GA.

  • Blood demands handle just by Nitroglycerine, Hydralazine, labetalol, Intravenous & sublingual Nifedipine, with continuing CTG watching all through preeclampsia scenario study ppt connected with typically the drugs.
  • In this have to deal with from troublesome throat intended for a powerful vital C.S.

    Which will is usually ideal (neuroaxial blockade vs G.A.)??

Consider neuroaxial obstruct with regard to platelet rely about 100,000 & platelet rely for 50,000 can come to be protected supplied that platelet performance is actually ordinary, implement platelet functionality lab tests simply because TEG, platelet operate assay (PFA-100)

Intraoprative

  • For spine :
  • be willing to get blood vessels strain shiifts.
  • Treat hypotension from :
  • Left uterine displacement
  • Fluids
  • Ephedrine and also phenylephrine
  • Remember which usually pre-eclampsia men and women really are further confidential to make sure you vasopressor effects

Spinal in opposition to epidural anesthesia:

  • Severe hypotension transpiring around pre-eclampsia anticipated in order to intravascular fullness contraction by using any attack involving sympathectomy
  • Although all of us discover which epidural comes with far better management with sympathectomy, current studies tend to be teaching basically no serious distinction through hypotension involving all of them
  • Spinal is without a doubt more desirable compared with epidural just for catastrophe C.S.

    preeclampsia instance study ppt

    in sequence to help you keep clear of G.A.

GA: In the event that there is actually contraindication to help regional anesthesia

  • Aspiration prophylaxis
  • Preoxygenation& denitrogenation
  • Rapid string induction having steady endotracheal intubation expected for you to throat edema with the help of pre induction nirtoglycerine or even labetalol
  • Consider wake up intubation with regard to Mallampati 3 (the case)
  • DON’T FORGET
  • Mg++ potentiates muscles relaxant effect
  • Preinduction arterial sections around critical preeclampsia
  • Never ergometrine

Postoperative

  • Postoperative analgesia & emptying connected with your bladder
  • Monitoring should really be persisted to get 24-48 hrs following distribution credited to be able to opportunity progress involving eclampsia for the reason that very well because the actual possibility related utilizing magnesium treatment
  • The location associated with management: work & sending, ICU or maybe ground is actually the choice from any general practitioner led by means of the actual patient’s health-related the reeves tale

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