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Acute Coronary Syndrome V: Nursing Management

Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
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Pre-eclampsia-eclampsia admitted to critical care unit.

José Rojas-Suarez1, Paulino Vigil-De Gracia

  • 1Critical Care Unit, Clínica de Maternidad Rafael Calvo, Grupo de Investigación en Cuidados Intensivos y Obstetricia, Universidad de Cartagena, Cartagena, Colombia.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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Summary

Women with HELLP syndrome, with or without eclampsia, face increased risks of severe complications and death. HELLP syndrome significantly impacts maternal outcomes in eclampsia cases.

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Area of Science:

  • Obstetrics and Gynecology
  • Critical Care Medicine
  • Maternal Health

Background:

  • Hypertensive disorders in pregnancy are a leading cause of maternal morbidity and mortality.
  • Understanding the specific impact of conditions like HELLP syndrome on critical care outcomes is crucial for improving patient management.

Purpose of the Study:

  • To evaluate the outcomes of women admitted to the critical care unit for hypertensive disorders.
  • To compare the clinical characteristics and outcomes of severe pre-eclampsia, eclampsia, HELLP syndrome, and HELLP with eclampsia (HEEH).

Main Methods:

  • A retrospective study conducted in Cartagena, Colombia, from January 2006 to December 2009.
  • Patients were categorized into four groups: severe pre-eclampsia, eclampsia, HELLP syndrome, and HEEH.
  • Data collected included parity, gestational age, mode of delivery, need for mechanical ventilation, blood pressure levels, inotropic support, hospitalization duration, organ dysfunction, and maternal mortality.

Main Results:

  • A total of 217 cases were analyzed, with severe pre-eclampsia without HELLP being the most frequent diagnosis (39.2%).
  • Hospitalization duration and multiple organ dysfunction were significantly higher in patients with HELLP syndrome and HEEH.
  • Maternal mortality was 2.3% (5 deaths), primarily due to intracranial hemorrhage, intra-abdominal bleeding, and pulmonary complications.

Conclusions:

  • HELLP syndrome, with or without eclampsia, is associated with significantly increased maternal morbidity and mortality.
  • The presence of HELLP syndrome is a critical factor influencing maternal outcomes in cases of eclampsia.