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A 20-year-old woman referred from midwife with note primagravida in 32 weeks of gestation
with gestational hypertension to Obgyn Polyclinic. From anamnesis, patient didn’t ANC regularly.
The blood pressure was 180/120mmHg and dipstick urine examination revealed proteinuria +3.
From fundal height measurement revealed 24 cm. The doctors in charge give Magnesium
sulphate solution intravenously to prevent eclampsia, anti-hypertensive drugs to decrease blood
pressure and planning to give dexamethasone every 12 hours for 2 days for lung maturation. The
doctor also plans to do fetal biometry measurement and fetal wellbeing using ultrasound.
Unfamiliar terms:
1. Fetal Biometry Measurement: Measurement of the fetal weight using the help of ultrasound
STEP 2
2. Why the doctor have to give MgSO4? And why it can prevent eclampsia?
7. What’re the sign and symptoms of preclamsia? What’s the danger of it?
9. Is the fundal height of 24 cm normal? What’s the expected normal fundal weight of each gestational
week?
STEP 3
1. Why the doctor have to give MgSO4? And why it can prevent eclampsia?
The MgSO4 prevent the exitacion by binding to the muscle receptor, by blocking the Ca channel.
It’s an anticonvulsant therapy
It shouldn’t be given more than 5 days: it could couse respiratory distress
To prevent eclampsia the mother take antihypertention and corticosteroid drug
Maternal:
Fetal
placenta
6. What’re the sign and symptoms of preclamsia? What’s the danger of it?
Depends wheter it’s symmetric or asymmetric. Asymmetric have better prognosis because the
restriction happen in late stage of pregnancy.
The later G.A the better the prognosis
9. Is the fundal height of 24 cm normal? What’s the expected normal fundal weight of each gestational
week?
Management:
Near term better if it’s terminated. If it’s IUGR added by oligohydramnion we should terminate
it if it’s > 34 weeks. Use Caesarean Section
We need to make sure the lung mature enough. Use corticosteroid to make it mature.
STEP 4
1. Why the doctor have to give MgSO4? And why it can prevent eclampsia?
The MgSO4 prevent the exitacion by binding to the muscle receptor, by blocking the Ca channel.
It’s an anticonvulsant therapy
It shouldn’t be given more than 5 days: it could couse respiratory distress. Because of the
overdose, the intercostal muscle can be weakened.
To prevent eclampsia the mother take antihypertention and corticosteroid drug
Intramuscular transmission is better than intervascular.
Maternal
i) Nutritional
ii) Parity
iii) Social deprivation
iv) Vascular disease
v) Anemia
vi) Antiphospolipid AB
vii) Ectopic pregnancy
viii) Chronic renal disease
Fetal
i) Fetal infection
ii) Congenital anomaly
iii) Congenital malformation
iv) Chromosomal anomaly
v) Multiple gestation
Placenta
1) Chorioangioma
2) Chronic partial placenta separation
3) Placenta previa
4) Poor placentation
6. What’re the sign and symptoms of preclamsia? What’s the danger of it?
Depends wheter it’s symmetric or asymmetric. Asymmetric have better prognosis because the
restriction happen in late stage of pregnancy.
The later G.A the better the prognosis
50% develop learning deficit 9 – 11 years old
9. Is the fundal height of 24 cm normal? What’s the expected normal fundal weight of each gestational
week?
Management:
Near term better if it’s terminated. If it’s IUGR added by oligohydramnion we should terminate
it if it’s > 34 weeks. Use Caesarean Section
We need to make sure the lung mature enough. Use corticosteroid to make it mature.
11. Is this an emergency condition? And how to manage it?
STEP 5