Component Task: Management of Eclampsia: Subsequent Management

This is an obstetric emergency care rendered by the midwife to a pregnant woman/client in a state of convulsion which is not related to an existing brain condition, followed by coma and posing a threat to client and foetus.

Aims

·         Stop convulsion

·         Reduce blood pressure

·         Delivery of foetus as soon as possible

·         Prevent injuries to the client and foetus

·         Resuscitate client and foetus

·         Prevent associated complications to client and foetus

Requirements

a.      Vital signs tray

b.      Delivery tray

c.      Induction tray

d.      Oxytocin

e.      Anticonvulsant e.g. Magnesium Sulphate

f.        Intravenous line tray

g.      IV Fluids e. g. Normal Saline or Ringer’s Lactate

h.      Urethral Catheter and Urine Bag

i.         Foetal monitor (manual /electronic)

j.         Intake and Output chart

k.       Oxygen Apparatus

l.         Suction Apparatus

m.   Perineal Pad

n.      Theatre Gown and Cap

o.      Consent Form

p.      Patella Hammer

q.      Urine Dipsticks

r.        Blood and Urine sample bottles

s.       Maternal and Child Health Record Book (Manual/Electronic)

Steps

1.        Monitor vital signs and reflexes every 4 hourly until client is stable, twice daily until discharge

2.      Administer maintenance dose of anticonvulsants every 4 hourly for 24 hours after delivery or the last convulsion, whichever occurs last

3.      Continue antihypertensive therapy as long as diastolic pressure is 110 mmHg

4.      Continue monitor client for signs of toxicity

5.      Monitor accurate fluid intake and output

6.      Arrange for transfer to a higher level if client’s oliguria persist for 48 hours after delivery, coagulation failure and persistent coma lasting more than 24 hours after convulsion

7.       Communicate progress of management to client and family

8.      Record and report all information in the Maternal and Child Health Book (Manual or Electronic)