Pre-eclampsia with an eclamptic fit. The fit is due to cerebral oedema, caused by the hypertension.
Management is very similar to pre-eclampsia.
- Labetalol is the beta-blocker of choice, given if BP is >150/100. Need to test U&Es, FBC and LFTs regularly looking for HELLP and other complications
- Treat eclamptic fit with IV magnesium sulphate. Perform obs every 15mins, looking for decreased RR or absent tendon reflexes – if either are present give calcium gluconate to reverse it.
Management of delivery
- >34wks: induce labour after steroids have been given and BP is controlled
- >37wks: induce labour within 24-48hrs
- Keep in hospital post natal >72hrs as eclamptic fits can occur post natally