Management and prevention of eclamptic seizures in severe pre-eclampsia and eclampsia.
Eclamptic seizures and seizure prophylaxis in severe pre-eclampsia and eclampsia. <
Relative - renal failure (reduce dose or magnesium).
Magnesium Sulphate IV
IV Pump
Give a loading dose followed by a continuous infusion for 24 hours or until 24 hours after delivery – whichever is the later.
MgSO4 4g IV diluted to 30mls over 20-30 minutes via a pump.
Dilute in dextrose-saline, 5% dextrose or N. Saline
MgSO4 1g/hr IV infusion.
20 g (40 ml) MgSO4 diluted to 1000 mls. Infuse at 1 g/hr (50 ml/hr) using a pump.
Dilute in dextrose-saline, 5% dextrose or N. Saline
Close monitoring with clinical assessment of the patient is essential. Re-evaluate the decision to continue the infusion, continuously.
Monitor the following:
Only continue the infusion if, after each 4 hour period:
These can all occur, but will be minimised if MgSO4 is administered slowly and the patient is observed as above.
Calcium gluconate 10%
Dose: 1G IV slowly over 7 minutes
Delay in starting Magnesium Sulphate in the woman with severe pre-eclampsia.
Inadequate monitoring of conscious level, respiratory rate, tendon reflexes and urine output.
Discuss with a specialist unit.
BC Women’s Maternal-Fetal Medicine Team 604 875 2161