Whew, that pretty much answers all of my  questions! 
Thanks very much for taking the time to share your
knowledge & experience, Jenny.

Whoops, thought of another question!  Black outs
reminds me... I have a friend who had a black out when
she was about 30/40 during a long day of shopping.

She was having an uneventful pregnancy, normotensive,
etc.  Had lots of baby movements both before & after
the blackout.  But was understandably freaked out
after the blackout.

If you were her midwife & she rang you describing
this, what would you suggest to her?

She went on to have a gorgeous baby at term in a birth
centre.

Jen


 --- Jenny Cameron <[EMAIL PROTECTED]> wrote: 
> 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

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