MedTop College

Chronic Hypertension with Super imposed Pre-eclampsia: This condition occurs in women with chronic hypertension before pregnancy who develop worsening high blood pressure and protein in the urine or blood pressure related complications during pregnancy

Eclampsia: It is the occurrence of fits unrelated to other cerebral condition in pregnant woman with Pre-eclampsia. Convulsions may occur during pregnancy, labour, puerperium. It is a complication of Pre eclampsia but can occur suddenly without prior signs

Management:

Monitor blood pressure, urine and fetal condition
If blood pressure worsens, manage as mild pre-eclampsia
If there are signs of severe fetal growth restriction or fetal compromise, arrange for immediate referral.
Counsel woman and family about danger signals of pre-eclampsia and eclampsia
Encourage additional periods of rest
Encourage woman to eat a normal diet
Do not give anticonvulsants, antihypertensives, sedatives or tranquilizers
Patients with mild PE do not need emergency treatment at the PHC
They should be referred to the nearest General Hospital for further care
In addition to the treatment of PIH, when BP is up to 160/110mmHg or more give IM magnesium sulphate (MgSo4) 5g (10mls) + 1ml lignocaine in each buttock and refer to a higher facility.

Women at risk of preeclampsia

- Young Mothers

- Primigravidas

- Past history of PIH,

- Family History of high BP,

- Multiple pregnancies,

- Molar pregnancy,

- Diabetes Mellitus,

- Renal diseases.

3. ANAEMIA: It is the reduction in quantity and quality of the RBC resulting in hemoglobin level below 10g/dl, or PCV 30 %, thereby reducing the oxygen carrying capacity of the blood.

Anaemia is classified into: -

Mild – 8-9.9g/dl
Moderate – 7-7.9g/dl
Severe - ˂ 7g/dl

It has the following effects on pregnancy: -

Increased incidence of preterm labour
Fetal distress
Low birth weight
Risk of perinatal mortality.

Signs and symptoms:

Tiredness
Weakness
Dizziness
Dyspnoea on exertion
Pallor (tongue, gums, nail beds, palms/sole)
Liver/spleen enlargement.

Management:

Refer any case of ˂ 7g/dl (it needs urgent blood transfusion)
Give haematinics and vitamin C
Treat malaria, hookworm
Treat any obvious infection
Avoid tea, coffee, or cola as it reduces Fe absorption
Give nutritional counseling
Re asses after 2 weeks, if Hb has not increased by 1g or continue to decreases refer.

4. URINARY TRACT INFECTION: Infection within the tract is one of the conditions which complicate pregnancy. It is normally bacterial which is influenced by the anatomical and physiological change in the urinary tract.

Signs and symptoms:

Dysuria
Increased frequency of micturation
L. Abdominal pain or suprapubic discomfort
Pus in urine

Untreated UTI i.e. cystitis eventually leads to pyelonephritis which have the following implication on pregnancy:

Intra uterine growth retardation
Preterm labour
Risk of congenital abnormality

Management:

Do urine/HVS and ECS (endocervical swab) for culture and sensitivity.
Advice to take plenty of water/fluid
Give erythromycin, or Ampiclox or Amoxycillin
Septrin is a commonly used antibiotic, although effective it should not be used in pregnancy as it is a folic acid antagonist and it may cause jaundice in the last trimester.

Refer any re – current case to higher facility.

Page updated

Google Sites

Report abuse