🧠 Tips for ICU Care of Eclampsia
✅ 1. Continuous monitoring is KEY
- BP, urine output, reflexes, respiratory rate, fetal monitoring
✅ 2. Maintain therapeutic magnesium levels
Check Mg level every 4–6 hrs
- Signs of toxicity = loss of reflexes
Antidote: Calcium gluconate 10 ml IV over 10 min
✅ 3. Avoid triggers for seizures
- Dim lights, reduce noise, keep suction ready
✅ 4. Control BP carefully
- Target SBP 140–160 mmHg
✅ 5. Watch for complications:
- Pulmonary edema, DIC, HELLP, AKI, ICH
✅ 6. Delivery doesn't mean recovery!
- Continue Mg sulfate for 24 hrs post last seizure
✅ 7. A multidisciplinary approach is essential
- ICU + OB/GYN + Anesthesia + Neonatology
🚫 Common Pitfalls to Avoid:
❌ Giving benzodiazepines before magnesium (unless status epilepticus)
❌ Missing atypical presentations (no hypertension or proteinuria)
❌ Ignoring reflexes / RR when giving Mg
❌ Overhydrating the patient → pulmonary edema
❌ Stopping Mg sulfate too early after delivery
📚 References:
- ACOG Practice Bulletin No. 222
- UpToDate: "Eclampsia"
- NICE Guidelines on Hypertension in Pregnancy