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
Give a loading dose followed by a continuous infusion for 24 hours or until 24 hours after delivery – whichever is the later.
MgSO4 4 -6 g IV diluted to 30mls over 15-20 minutes via a pump.
MgSO4 1-2 g/hr IV infusion.
Magnesium can cause respiratory depression and cardiac arrest - these are related to blood levels of magnesium. 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 minimized if MgSO4 is administered slowly and the patient is observed as above.
Calcium gluconate 10%
Dose: 1 g IV slowly over 10 minutes initially, if in arrest start at 1.5 – 3 g IV
Furosmide IV - as an adjunct to calcium gluconate - increases excretion of of magnesium
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