Eclampsia.

Eclampsia.

About the high risk of eclampsia testify:  severe headache, high hypertension (dyastolic BP> 120 mmHg), nausea, vomits, paropsis, pain.

Primary objectives of urgent help:

- stopping of cramps;

- renewal of communicating of respiratory tracts.

Tasks of intensive therapy after sessation of cramps:

- warning of the repeated convulsive attacks;

- removal of hypoxia;

- prophylaxis of aspiration syndrome;

- exigent labor.

First aid at development of attack of eclampsia.

Treatment in the case of attack of cramps begins in place.

Open out the chamber of intensive therapy or   hospitalize pregnant to the separation of intensive therapy.

Sick conclude on an even surface in position on left, quickly free respiratory tracts, opening a mouth and pulling out a lower jaw ahead, parallel will evacuate maintenance of mouth cavity. For possibilities, if the spontaneous breathing is stored, enter tube and conduct inhalation of oxygen.

Parallel with the conducted measures on renewal of adequate interchange of gases carry out the cannulation of peripheral vein and begin introduction of anticonvulsant preparations (sulfate of magnesium is bolus  4  g during  5  minutes intravenously, then supporting therapy 1-2 g/hour) under the careful control of АP and pulse. If the attacks last, intravenously enter to 2 g sulfates of magnesium (8 ml a 25% solution) during 3-5 minutes. In place of sulfate of magnesium additional to the bolus it is possible to use diasepam intravenously (10 mg) whether tiopental-sodium (450-500 mg ) during 3 minutes. If the attack of cramps lasts above ЗО of minutes, examine this state as eclampsia  status

If dyastolic АP remains at high level (> and 10 mmHg), conduct hypotensive  therapy.

All manipulations (cannulation of veins, urinary bladder, obstetric manipulations) conduct under general anaesthesia by thiopental-sodium or nitrous oxide with oxygen.

After liquidation of cramps conduct the correction of metabolic violations, water-electrolyte balance and ground-state, proteometabolism.

The inspections carry out after stopping of attack of cramps.

Consultation of neurologist and oculist.

Labor is carried out quickly.

Liquid forms of gestosis.

  1. Dermatosis of pregnant: dominant sign there is the itch of skin.
  2. Fatty dystrophy of liver: as a result of intoxication there is the fatty and albuminous regeneration of cages of liver. Sharp fatty dystrophy of liver is the absolute show to breaking of pregnancy.

3. HELPP-syndrome — this (Н) – hemolytic  anaemia, elivated liver ferments is enhanceable concentration of enzymes of liver in plasma of blood; Low piatelet (LP)  decline of level of thrombocytes. Thus a maternal death rate achieves 3,5%, and fetus — 79%. The physiopathologies changes at a HELLP-syndrome take place mainly in a liver.

Role of female dispensary in the prophylaxis of gestoses
  1. Selection of expectant mothers which belong to the group of risk.
  2. Planning of pregnancy to the women with the risk of development of gestosis : it costs to recommend the terms of conception so that development of pregnancy was on summer-autumn periods.
  3. Clinical supervision after pregnant by the gynaecologist and another types specialists.
  4. Removal of negative emotions in the way of life and on production.