Hello, why does the midwife decided to administer only oral nifedipine after seeing all the symptoms, BP, hyperreflexia? Why not giving hydralazine and MgSO4 to prevent seizures?
Yes we check the patellar reflex for accessing mgso4 toxicity. In the case of toxicity there is loss of patellar reflex. But they checked it before administration of mgso4 because they wanted to check for hyperreflexia. Deep tendon reflexes are increased in many women prior to seizures. That's why. Hope it clears your doubt😊😉
Hi Rosie yang...I'm a final year mbbs student. To the best of my knowledge, in this condition, although there is hypovolemia but tissues are overloaded. Also the urine output is severely decreased. So Excessive fluids or iv infusion will cause tissue overload and circulatory overload leading to pulmonary edema and adult Respiratory distress syndrome.
Thanks Rosie, we're glad you're finding them useful. As Jasmine says the reason we restrict fluid in severe pre-eclampsia is the risk of of pulmonary oedema, which used to be a leading cause of death in these women. Pre-eclampsia can lead to leaky capillaries, and to renal impairment, both of which predispose to pulmonary oedema unless fluids are carefully managed.
I wish someone would make a first person from the mums view.. What do the visual disturbances look like first person ? How does she feel? I think i may have developed preclampsia
Many thanks Salma. As you say, delivery of the baby will be the team's ultimate goal. However, it is vital to stabilise the mother first. The team's key clinical aims in severe pre-eclampsia will be: - senior review, and involve the multi-professional team - manage the blood pressure - prevent seizures (with MgSO4) - restrict fluids - make a plan for delivery All the while remembering good team-working in terms of: - communication within the team (e.g. using SBAR and 'closed-loop' communication), and with the mother - situational awareness (maintaining a clear overview, thinking ahead) - team roles and leadership
Thank you so much for these videos! I am a newly qualified midwife and want to be as prepared as I can be for emergency situations such as this one
You are so welcome!
Hello, why does the midwife decided to administer only oral nifedipine after seeing all the symptoms, BP, hyperreflexia? Why not giving hydralazine and MgSO4 to prevent seizures?
This is really helpful, team work and communication was effective.
Why we checked the patella reflex before MgSO4? Wasn't it a sign of magnesium toxicity?
Yes we check the patellar reflex for accessing mgso4 toxicity. In the case of toxicity there is loss of patellar reflex.
But they checked it before administration of mgso4 because they wanted to check for hyperreflexia. Deep tendon reflexes are increased in many women prior to seizures. That's why.
Hope it clears your doubt😊😉
Excellent video
hi, i'm a midwife student, thank you so much for these videos these are helping me a lot. can you tell me why we restrict fluids? thank you so much.
Hi Rosie yang...I'm a final year mbbs student.
To the best of my knowledge, in this condition, although there is hypovolemia but tissues are overloaded. Also the urine output is severely decreased. So Excessive fluids or iv infusion will cause tissue overload and circulatory overload leading to pulmonary edema and adult Respiratory distress syndrome.
Hope this helps❤
Thanks Rosie, we're glad you're finding them useful.
As Jasmine says the reason we restrict fluid in severe pre-eclampsia is the risk of of pulmonary oedema, which used to be a leading cause of death in these women.
Pre-eclampsia can lead to leaky capillaries, and to renal impairment, both of which predispose to pulmonary oedema unless fluids are carefully managed.
I wish someone would make a first person from the mums view..
What do the visual disturbances look like first person ? How does she feel? I think i may have developed preclampsia
Baby should have been delivered the moment preec
Many thanks Salma. As you say, delivery of the baby will be the team's ultimate goal. However, it is vital to stabilise the mother first.
The team's key clinical aims in severe pre-eclampsia will be:
- senior review, and involve the multi-professional team
- manage the blood pressure
- prevent seizures (with MgSO4)
- restrict fluids
- make a plan for delivery
All the while remembering good team-working in terms of:
- communication within the team (e.g. using SBAR and 'closed-loop' communication), and with the mother
- situational awareness (maintaining a clear overview, thinking ahead)
- team roles and leadership