Eclampsia may be defined as the development of seizures in association pre-eclampsia. To recap, pre-eclampsia is defined as:

• condition seen after 20 weeks gestation
• pregnancy-induced hypertension
• proteinuria

Management

• ABC, then move patient to left lateral tilt position to reduce aortocaval compression

Magnesium sulphate is used to both prevent seizures in patients with severe pre-eclampsia and treat seizures once they develop. Guidelines on its use suggest the following:

• should be given once a decision to deliver has been made
• in eclampsia an IV bolus of 4g over 5-10 minutes should be given followed by an infusion of 1g / hour
• urine output, reflexes, respiratory rate and oxygen saturations should be monitored during treatment
  • respiratory depression can occur: calcium gluconate is the first-line treatment for magnesium sulphate induced respiratory depression
• treatment should continue for 24 hours after last seizure or delivery (around 40% of seizures occur post-partum)

Other important aspects of treating severe pre-eclampsia/eclampsia include fluid restriction to avoid the potentially serious consequences of fluid overload