Eclampsia should be considered in all women presenting with a seizure after 20 weeks’ gestation or in the postpartum period. Unless a seizure can be clearly attributed to epilepsy, magnesium sulphate should be commenced - Jenni Cooper & Naomi Primrose


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Eclampsia in the ED: Presentation, Differential Diagnosis, and Treatment

The mainstay of treatment for eclampsia is magnesium sulfate, both as seizure prophylaxis in patients with preeclampsia and as a first line antiepileptic when seizures occur...

The most recent ACOG guidelines recommend initial dosing in any patient suspected to have eclampsia includes a loading dose of 4 or 6 grams over 15-20 minutes, followed by maintenance with continuous infusion at a rate of 2 g/hr. If IV magnesium sulfate is not available or IV access cannot be established, administer a 10g loading dose IM (5g IM in each buttock) followed by 5g IM every 4 hours.

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 Eclampsia in the ED: Presentation, Differential Diagnosis, and Treatment

Eclampsia can present during the antepartum, intrapartum, or postpartum period.

TeachMe ObGyn

Eclampsia is defined as the occurrence of one or more convulsions in a pre-eclamptic woman in the absence of any other neurological or metabolic causes. The majority of seizures occur in the post-natal period (44%), but they can also occur in the antepartum (38%) or intrapartum (18%) settings.

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