Now, Rules to Treat Eclampsia
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27 December 2008
by Umesh Isalkar
Guidelines Ready And Expected To Bring Uniformity And Standardised Care In Country
An injection of magnesium sulphate given at the outset of the symptoms of eclampsia (also called pregnancy–induced hypertension or PIH) can reduce mortality rate drastically. This and other guidelines formulated by the national registry of eclampsia formed by the Indian College of Obstetrics and Gynaecology (ICOG) of the Federation of Obstetrics and Gynaecological Societies of India (FOGSI) will be followed and replicated at clinical establishments across the country.
The guidelines, which were long overdue, are now ready and expected to bring uniformity and standardised care in treating eclampsia across the country. “A four-day national conference of FOGSI is scheduled at Jaipur from January 4 during which these guidelines will be released,” said gynaecologist Sanjay Gupte of Gupte Hospital and Centre for Research in Reproduction, Pune who is the national co–ordinator of the registry in the country. These guidelines will also be available for ready reference at the FOGSI’s website, he added.
“Uncontrolled rise in blood pressure during pregnancy can lead to fits which is called as ‘Eclampsia’. Vigilant and careful antenatal care from the time of conception can help identify the mothers at risk, detect hypertension early and anticipate and prevent the condition,” said Gupte.
“There is a serious lack of awareness among people about this silent common condition associated with pregnancy. Especially in our country all the factors postulated to be the cause of this condition exist like under–nutrition, early pregnancies, micronutrient deficiencies etc,” said gynaecologist Girija Wagh, the national assistant co–ordinator of the registry. The guidelines will help doctors administer standardised uniform care. “This will also further enhance the purpose of the registry to evaluate treatment and the outcome and in turn reduce the maternal mortality and morbidity,” Wagh said.
Gupte said that guidelines for treating eclampsia are in practice in the west since long. “But since the ground realities like our eating habits, our diet that is mostly plant based (vegetarian) etc. are different from those in the developed countries, we cannot put their guidelines into practice. Hence there was an urgent need for formulating a blueprint for our people,” said Gupte.
Considering practical difficulties of implementation in small places, we have formed two sets of instructions minimum desirable guidelines for small clinical establishments in rural areas and an ideal set for tertiary care centers, he added. This effort will go a long way in helping improve women’s health in our country, said Wagh.
Also referred to as toxaemia, pre–eclampsia is a condition in pregnant women marked by high blood pressure accompanied with a high level of protein in the urine. Eclampsia is the final and most severe phase of preeclampsia and occurs when pre–eclampsia is left untreated.
The exact causes of preeclampsia and eclampsia are not known, although some researchers suspect poor nutrition, high body fat or insufficient blood flow to the uterus as possible reasons.
Pre–eclampsia is most often seen in first–time pregnancies and in pregnant women over 40 years old as well as among women who marry at an early age.