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    Evolution of Mgso4 For Eclampsia

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    albertriantho
    1) Magnesium sulfate has become the standard treatment for preventing seizures in women diagnosed with preeclampsia and eclampsia due to its effectiveness. 2) Historically, various treatments were used for preeclampsia and eclampsia such as sedation, phlebotomy, gastric lavage, and digitalis, but magnesium sulfate was found to be the most effective at preventing seizures. 3) Magnesium sulfate works by blocking neuromuscular transmission and reducing the amount of acetylcholine in the end plate, which helps control muscular excitability and prevents seizures.

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    Evolution of Mgso4 For Eclampsia

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    albertriantho
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    1) Magnesium sulfate has become the standard treatment for preventing seizures in women diagnosed with preeclampsia and eclampsia due to its effectiveness. 2) Historically, various treatments were used for preeclampsia and eclampsia such as sedation, phlebotomy, gastric lavage, and digitalis, but magnesium sulfate was found to be the most effective at preventing seizures. 3) Magnesium sulfate works by blocking neuromuscular transmission and reducing the amount of acetylcholine in the end plate, which helps control muscular excitability and prevents seizures.

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    1) Magnesium sulfate has become the standard treatment for preventing seizures in women diagnosed with preeclampsia and eclampsia due to its effectiveness. 2) Historically, various treatments were used for preeclampsia and eclampsia such as sedation, phlebotomy, gastric lavage, and digitalis, but magnesium sulfate was found to be the most effective at preventing seizures. 3) Magnesium sulfate works by blocking neuromuscular transmission and reducing the amount of acetylcholine in the end plate, which helps control muscular excitability and prevents seizures.

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    56 views23 pages

    Evolution of Mgso4 For Eclampsia

    Uploaded by

    albertriantho
    1) Magnesium sulfate has become the standard treatment for preventing seizures in women diagnosed with preeclampsia and eclampsia due to its effectiveness. 2) Historically, various treatments were used for preeclampsia and eclampsia such as sedation, phlebotomy, gastric lavage, and digitalis, but magnesium sulfate was found to be the most effective at preventing seizures. 3) Magnesium sulfate works by blocking neuromuscular transmission and reducing the amount of acetylcholine in the end plate, which helps control muscular excitability and prevents seizures.

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    EVOLUTION OF

    MAGNESIUM SULPHATE
    FOR ECLAMPSIA

    Tan Gabriella Heidina Handoko 01073170123


    Penguji dr. Iwan, Sp. OG(K)
    o MedCrave
    o Reproductive System and Sexual Disorder International Journal, Volume
    2 Issue I – 2018
    o Published January 19, 2018
    Introduction
    Pre- MgSO4
    o Most (99%) of the clampsia
    63,000 woman
    worldwide that die
    every year from
    preeclampsia and
    eclampsia are in
    low in-come Eclampsia
    countries
    Hypertensive Disorders of
    Pregnancy

    Preeclampsia Eclampsia
     Multi systemic disorder,
    characterized by  When a woman with
    hypertension and proteinuria PREECLAMPSIA experiences
    occurring after the 20th week
    of pregnancy in a woman generalized tonic-clonic
    who has been previously seizures during pregnancy or
    normotensive and non- shortly after delivery
    proteinuric
    Symptoms of Preeclampsia

    BP ≥ 140/90 mmHg atau Proteinuria > 300mg/hari atau dipstick


    ≥ 160/110 mmHg urin > 1+
    Trombositopenia: trombosit < 100.000/ Edema Paru
    mikroliter
    Gangguan ginjal: Kreatinin serum > 1,1 Gejala neurologis: Stroke, nyeri kepala,
    mg/dL gangguan visus
    Gangguan liver: Peningkatan Gangguan pertumbuhan janin:
    transaminase 2 kali normal dan atau Oligohdramnion, FGR, absent or
    adanya nyeri di daerah epigastrik reversed end diastolic velocity (ARDV)
    The Preeclampsia Syndrome that
    Results in Eclampsia
    Abnormal
    trophoblastic
    2 basic invasion of uterine
    abnormalities blood vessels
    Preeclampsia

    Endothelial cell
    dysfunction
    Mechanism of Seizure in
    Preeclampsia

    Cerebral Edema
    Eclampsia can thus be
    ischemic necrosis formation
    considered as a form of
    Hypertensive
    CT & MRIencepahlophaty Vasogenic origin resulting
    Or from rapid rise in BP
    Posterior reversible
    encephalophaty
    Areas of vasospasm Overcomes the myogenic
    which may cause syndrome vasoconstriction of
    nercrosis cerebral arteries & arteriols
    Brief Historical

    SEDATION
    Phlebotomy
    Work of Stroganoff who
    introduced
    o Morphine18th
    o Chloral Hydrate
    Gastric o O2
    Carthasis
    lavage o Digitalis
    Seizure Prophylaxis
    Discussion
    Magnesium Sulphate
    Magnesium Level in Normal &
    Preeclampsia Pregnancies

    1-2 %
    Extrace- Total
    Important role in
    llular neuro-chemical transmission &
    muscular excitability body
    MgSO4
    Normal plasma magnesium 1.5 – 2.5 mEq/L
    30%
    bound to
    albumin
    Magnesium Level in Normal &
    Preeclampsia Pregnancies
    Magnesium deficiency

    Manifest as neurological
    symptoms
    o > Reversed at delivery
    Muscle excitability
    o Seizures
    Within 24 hours
    o Tremors

    Hypomagnasemia
    Followed by
    hypocalcemia &
    In 2nd & 3rd trimesters
    hypokalemia
    Administration

    IV (2-4g dose up to
    1g/min)
    MgSO4
    IM (6g loading dose
    followed by 2g/h)
    Cara
    Pemberian
    MgSO4:
    Protocols: Pritchard, Zuspan and Sibai
    Pharmacology

    Blocking
    neuromuscular
    transmission &
    decreasing the
    amount of
    acetylcholine in
    end plate
    Common Adverse Side Effect

    Cardiac arrest:
    Terms:
    At higher serum magnesium level
    • CaRespiratory
    Glukonas 10%
    Paralysis:
    • Patella> 13reflex
    mEq/L
    (+)
    • Urine output minimal
    Areflexia:
    0.5 ml/kg/hour
    8 to 10 mEq/L
    •Vasodilatation to
    improve blood flow
    in the pulmonary, •Renal failure
    renal, hepatic, •Myasthenia gravis
    CNS, and placental •Myocardial ischemia
    circulations thereby or failure
    delaying the need
    for delivery
    Other Seizure Prophylaxis

    The Eclampsia Trial Collaborative Group. Which


    anticonvulsant for women with eclampsia? Evidence from the
    collaborative eclampsia trial. Lancet. 1995;345:1455–1463.
    Reduce risk of recurrent seizures in eclamptic women by 52%
    when compared to diazepam
    Reduce risk of recurrent seizures in eclamptic women by 67%
    when compared to phenytoin
    Mortality

    Associated with patient transfers to busy units with


    lower staffing levels, chaotic environments
    Should increasing staff ratios to allow for proper
    monitoring
    Monitoring is the key to prevention of toxicity
    Conclusion

    MgSO4 is the most effective


    remedy in the history of
    treatment of eclampsia
    Thankyou  Any Question?

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