PRESENTED BY: AMINATOU LEKA

1. A CASE STUDY REPORT ON PREECLAMPSIA CARRIED OUT DURING AN INTERNSHIP AT THE REGIONAL HOSPITAL BAMENDA FROM 7 DECEMBER 2017 TO 7 JANUARY 2018 PRESENTED BY: AMINATOULEKA 25 APRIL 2018 SUPERVISED BY DR MFONFU DANIEL

2. Definition of Preeclampsia: Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys – pitting oedema and proteinuria. Preeclampsia usually begins after 20 weeks of pregnancy in a woman whose blood pressure had been normal. Even a slight rise in blood pressure may be a sign of preeclampsia ( Mayo Clinic Staff) Pre-eclampsia or preeclampsia (PE) is a disorder of pregnancy characterized by high blood pressure and a large amount of protein in the urine. (http://en.wikipedia.org/wiki/Pre-eclampsia)

3. MOTIVATION Literature on preeclampsia says pre-eclampsia occurs at about 20 weeks of pregnancy but in this case preeclampsia started when the pregnancy was at term. This preeclampsia at term motivated me to study it.

4. Pathophysiology • During normal pregnancy, the placenta undergoes process of vascularization to allow for blood flow between the mother and fetus. (http://en.wikipedia.org/wiki/Pre-eclampsia

6. Abnormal development of the placenta leads to poor placental perfusion. The placenta of women with preeclampsia is abnormal and characterized by poor trophoblastic invasion

7. DEMOGRAPHIC IDENTITY OF THE CASE ON ADMISSION Name: patient x; Age: 19 years; Sex: female; Address: mile 90; Occupation: student; Religion: Presbyterian; Ward: Postnatal in private room one; Bed number: 2; Blood group O Nationality: Cameroonian LMP 09/03/2017 ; EDD16/12/2017 DOA: 19/12/17 Gravida1

8. CONDITION ON ARRIVAL OF THE PATIENT IN THE WARD. From the casualty assessment, the 19 years old female gravida 1, accompanied by her mother at 3pm with complaints of 40weeks +3days gestational age . From the Dr`s consultation, she has severe preeclampsia with blood pressure of 160/87mmHg,pulse of 104b/m, swelling legs and ankles. An induction of labour was recommended 1/4cytotec by the Doctor . The fundal height of 40cm and foetal heart beat of 134b/m.

9. The medical prescription was as follows: • - Ringer lactate • - Magnesium sulfate • - ¼ cytotec

11. The induction failed and the doctor recommended a CS that was done on 21/12/2017. Description of the Caesarean Section: The CS was done under general anaesthesia. A live male baby was extracted with an Apgar score of 10. • Post-operative prescription: • Magnesium • Novalgin • Ampicillin

17. The review of medications did not reveal any reaction by the patient DISCHARGE SUMMARY Date of admission 19 12 2017 Date of discharge 2412 2018 Treatment received Noualgin, magnesium sulphate, ampicilline, oxytocin, Response to treatment: the induction failed. She had a CS; a live male baby was delivered with Apgar 10.

18. DISCHARGE SUMMARY (continues) CONDITION ON DISCHARGE Patient after receiving her medications was in good and satisfactory condition with no complain .the patient left the hospital with her baby ,thus in a healthy condition Home Treatment Oral rapiclav and antalgex 5.7 Advice on discharge Patient was advised on hygiene, proper, breast feeding of the baby and to come back if she has any complain.

19. DISCHARGE SUMMARY (continues) And also to go for family planning 5.8 Appointment after six weeks for post partum examination Follow up: After patient was discharged, she went for appointment and was in good condition, on calling she was very happy and satisfied for nursing care given to her in the hospital and at home

20. Conclusion The case study internship carried at the Bamenda Regional Hospital was a successful one because my case was well managed by the medical and nursing staff The internship was a successful one because we did not only nurse a patient with preeclampsia but other normal delivery both the mothers and their babies. CS is recommended for all cases of preeclampsia since it is due to poor vascularization of placenta

21. THANKS!