Re: [ozmidwifery] seizure at birth

[Jenny Cameron]

Most unusual. Usual practice would assume eclampsia until proven otherwise. 
I once had a woman, normotensive, postdates & multigravid  have a grand mal 
seizure immediately following an ARM for induction of labour. Fortunately 
the Obs was just outside the door washing his hands. On questioning she gave 
a history of frequent blackouts during pregnancy. Didn't think to report it! 
Subsequently diagnosed as epileptic. The actual seizure is not a problem for 
the woman (we need to protect her from physical injury). It is certainly a 
problem if the baby is still in utero as he will be anoxic for the period of 
the seizure. The major morbidity for the woman arises from the ischaemic 
cerebral damage and possible stroke from the hypertension. Never, ever 
underestimate pre-eclampsia. Beware of the woman with upper epigastric pain 
and be very wary of the 'twitchy' woman. New grads don't be afraid but be 
vigilant. Women rarely become eclamptic without some warning. Medical 
science is very good at detecting pre-eclampsia. The management of 
pre-eclampsia has changed dramatically over the period of time I have been a 
midwife. It so much better now.

As far as midwifery responsibility, if a woman seizures, you need to
1) Call for urgent medical help
2) Protect her from injury
3) Take BP.
4) Prepare for medication to lower hypertension..
5) Monitor the baby...N.B.mother takes priority. If she is well oxygenated 
the baby will be. Therefore sort her out first.
Happy midwifing
Jenny

Jennifer Cameron FRCNA FACM
ProMid
Professional Midwifery Education  Service
0419 528 717
----- Original Message ----- 
From: "Jen Semple" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, November 17, 2004 2:02 PM
Subject: [ozmidwifery] seizure at birth


--- Graham & Wende Smith <[EMAIL PROTECTED]>
wrote:
Sunday night an asymptomatic primip had a seizure
with >a head on view.
Wende, do  you mind sharing more with me/us about this
experience?  I'm an about-to-graduate BMid student &
this sounds really scary!
If someone has a seizure during late pregnancy,
labour, birth do you always assume it's eclampsia even
if she's asymptomatic & treat accordingly?
Cheers, Jen
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