Preeclampsia and Hypertensive Disorders

Sibai, Baha M.

doi:10.1016/b978-0-323-32108-2.00031-7

Cited by 3 publications

(1 citation statement)

References 251 publications

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“…13 Some severe feature findings include a) pulmonary edema or hypoxia, b) renal insufficiency, serum creatinine >1.1 mg/dL or doubling creatinine in the absence of kidney disease, c) new-onset headache, d) presence of visual disturbances, e) persistent epigastric or right upper quadrant pain, f) impaired liver function tests, g) generalized weakness, h) bleeding at intravenous insertions, i) thrombocytopenia <100,000 and j) altered mental state. 14 …”

Section: Debriefing and Evaluation Pearlsmentioning

confidence: 99%

Eclampsia

Yang

Sangal

Conlon

2021

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Audience Emergency medicine residents. Introduction Eclampsia is the development of a generalized seizure in pregnant patients with hypertension of pregnancy. 1 Eclampsia exists on the spectrum of hypertension-related disorders in pregnancy, occurs in 1 out of 1,000–10,000 deliveries, 1 – 3 and is associated with significant maternal and fetal morbidity and mortality. 4 Given the emergent nature of eclampsia and the benefit of rapid treatment, emergency medicine (EM) physicians need to quickly recognize and treat this rare pathology. Although residents have three to four years before becoming an attending, not all emergent pathologies may present clinically during their training. It is important to simulate rare, treatable conditions such as eclampsia to give learners exposure confidence in managing this disease. Educational Objectives By the end of this simulation session, learners will be able to: Demonstrate care of a gravid patient with altered mental status Demonstrate care of a gravid patient with seizures Recognize care involved in assessment of fetal status Execute appropriate subspecialty consultation Recognize the clinical signs and symptoms of eclampsia Distinguish different treatment options for eclampsia Identify magnesium toxicity and reversal agent Differentiate the spectrum of preeclampsia Educational Methods As an educational strategy, simulation allows learners to partake in experiential learning. By creating a safe and supportive learning environment, simulation allows learners to facilitate deliberate practice and transfer learning in debriefing sessions. High-fidelity sessions involve software and technology to mimic realistic patient environments, which also activate learners’ affective states to aid in decision-making abilities in complex medical cases. This session was conducted using a high-fidelity mannequin, SimMom (Laerdal), and a controlling Laerdal LLEAP Software. Faculty-led debriefing followed the simulation case and included discussion regarding presentation, spectrum, and management of the obstetrical emergency. 5 Research Methods Resident participants completed an evaluation form consisting of questions on a 5-point Likert scale assessing the realism and usefulness of the simulation. Results All 18 residents who participated in the simulation completed an evaluation form, and all agreed or strongly agreed the case was realistic and useful. Discussion Incorporating high-stakes, low-frequency presentations through simulation can be readily applied in residency education and well-received by residents. Increasi...

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Section: Debriefing and Evaluation Pearlsmentioning

confidence: 99%

Eclampsia

Yang

Sangal

Conlon

2021

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Common Obstetric Complications and Emergencies

Deering

A Practical Manual to Labor and Delivery

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Preeclampsia: Acute Complications and Management Priorities

Witcher

2018

AACN Advanced Critical Care

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Acute complications of preeclampsia contribute substantially to maternal and fetal morbidity and mortality. The considerable variation in onset, clinical presentation, and severity of this hypertensive disease that is unique to pregnancy creates challenges in identifying risk factors for clinical deterioration. Delivery of the fetus remains the only definitive treatment for preeclampsia. Surveillance of signs and symptoms and laboratory parameters consistent with progression in severity requires an appreciation of the dynamic and progressive nature of the disease. This article provides a comprehensive overview of the pathophysiology of preeclampsia, setting the foundation for discussion of management priorities for acute complications that pose the greatest risks to maternal health.

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Preeclampsia and Hypertensive Disorders

Cited by 3 publications

References 251 publications

Eclampsia

Eclampsia

Common Obstetric Complications and Emergencies

Preeclampsia: Acute Complications and Management Priorities

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