Management of Eclampsia and Pre-eclampsia in Pregnancy: Anesthesia Considerations by Dr. Amassi Yakdhan
This comprehensive guide covers the management of hypertension terms in pregnancy, including chronic hypertension, gestational hypertension, pre-eclampsia, and eclampsia. It discusses the risks associated with high blood pressure during pregnancy and the potential complications such as multi-organic failure and poor placental blood flow. The anesthetic plan for handling eclampsia, including considerations for general anesthesia and neuraxial anesthesia, is also detailed along with preparations and medications. Additionally, it addresses the challenges of difficult airway management in patients with eclampsia.
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Eclampsia & pre eclampsia in pregnancy 3rd lec. / anesthesia / 4th stage By dr. Amassi Yakdhan _ 2023 2022
Hypertension terms in pregnancy Chronic HT : high BP before or during 1rst 20wk of pregnancy. Chronic HT +Pre eclampsia : it can worsen by MOF. Gestational HT : develop after 20wk without MOF. Pre eclampsia : HT develop after 20wk ,it can lead to MOF. Eclampsia : pre eclampsia + convulsion + MOF. Why high BP is a problem during pregnancy : MOF : multi organic failure or damage. Future CVS diseases placental blood flow & placental detachment ) abruption &(fetal growth restriction IUGR. Premature delivery Maternal , baby or both death.
Anesthetic plan GA : it establish if Bleeding tendency start Patient in convulsions , or near to by happen. Sever fetal distress Keep in mind difficult airway management. Neuraxial anesthesia : Its of choice , unless convulsions or bleeding tendency are start. Caution against sever drop in BP Caution against using vassopressor Keep in mind difficult application.
Anesthetic preparation 2large bore cannulation Bladder cathetrization Full monitering of vital sign , input & out put. Preparation of difficult airway managment. Labrotary preparation Bgp & Hb , preparation of blood , FFP , cryo Protein urea& creatinine plattlet count ( pt , ptt) , bleeding tendency , liver enzyme
Considerations about GA Patient may come in convulsion or coma (post ictal ). May come in vomitting , pneumonia ,low SPO amede yranomlup . May come with sever bleeding of APH or PPH. Difficult airway managment Mucosa easy to touch Large toungue& breast , short neck Over sympathetic system during ETT & laryngoscopy. RSI 2 noitaripsa ,
What are your medications Premedication : Opioid like fentanyle Zylocaine 1.5 mg / kg Metoprolol 1 mg _ 4 mg Antacids Metoclopromide AHT Premedications : Mg sulphate40 mg / kg Nifidipine or aC sa, yllaro temodla rekcolb lennahc Hydralyzin or enilosirpa 4 ,as vasodilators as venous Angesid & lairetra sa , enirecylgortin ro suonev . Diuretics or mannitol ot citcalyhporp amede larberec mg bolus dose
Induction &Post operative managment Induction : propofol or pentothal + 10 mg ketamin + atracurium + RSI Maintaince :N2O + O Managment of pain Managment of BP Deep extubation HDU admittion Close monitering vital signs , input & out put Close monitering to BP , convulsion Good analgesia . Lab. Investigation about organic failure Medical consultion 2 elatilov+
Common complications of pre eclampsia HELLP Syndrom MOF Cerebral edema Pulomnary edema & heart failure Aspiration pneumonia DVT Pulmonary embolisim Endothelial damage : of blood vessles ,lead to be more permeablity of fluids that given , so easy to get pulmonary edema So , eht ylppus uoy nehw lufrac eb v.i yb aispmalce erp fo tneitap sdiulf
