Medical and nursing management combines seizure and blood pressure control with airway care, close observation and preparation for obstetric management.
Immediate measures
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Call for extra help and control seizures with magnesium sulfate using intravenous or intramuscular regimens.
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Place the patient in the left lateral recumbent position, maintain the oral airway and prevent injury from tongue biting or falls.
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Establish intravenous access using one or two wide-bore cannulas and insert a Foley catheter with a urometer.
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Labetalol and hydralazine are listed for control of hypertension; diuretics are listed for pulmonary edema.
Airway and oxygenation
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Lateral positioning helps avoid aspiration. Remove vomitus and oral secretions by frequent suctioning.
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The prose specifies oxygen through a face mask at 8–10 L/minute to prevent respiratory acidosis.
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Monitor oxygenation with a transcutaneous pulse oximeter. Arterial blood gas analysis is needed if oxygen saturation falls below 92%.
Supervision and investigations
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Provide intensive care facilities and constant supervision by a doctor or at least a trained midwife.
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Monitor vital signs, fetal status and magnesium toxicity.
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Organize blood investigations including CBC, AST, ALT, LDH, creatinine and uric acid, together with urine analysis for protein.
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Obtain a history from relatives covering the diagnosis of eclampsia, duration of pregnancy, number of fits and medication administered before arrival.
Obstetric care
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The management outline includes delivery by 6–8 hours, prevention of complications and postpartum care.