Can Anyone Help Me With This Question?

[JLogefeil]

Is there any difference between the way they manage a pregnant woman with status epilepticus in the er and a women with status epilepticus who isn't pregnant? Or is it all treated the same?
If they treat them both differently, how so from the other?

 

[Nakamova]

This is usually the drill if a pregnant women is in status:

-- Check vital signs, including oxygenation
-- Check the fetal heart rate or fetal status
-- Rule out eclampsia
-- Administer lorazepam
-- Administer a loading dose of phenytoin (or, if phenytoin is counterindicated, phenobarbital) and continue cardiac monitoring.
-- Check labs, including electrolytes, AED levels, glucose, and toxicology screen.
-- If fetal testing results are nonreassuring, then emergency delivery may be the next step.

So the main difference is that everything is done while keeping an eye on how the fetus is doing. If you have specific concerns (like with your phenytoin allergy), you should check in with your neurologist and your OB/GYN to make sure they're on the same page.

 

[JLogefeil]

You still get med's even when your pregant? I thought it would all be unsafe.

 

[Nakamova]

In this case, status is of more risk to the fetus than the one-time administration of the anti-seizure meds.