Clinical Management and Outcome of Eclampsia at Rajavithi Hospital
PRATHARN CHINA YON, M.D.*
Affiliation : * Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok 10400, Thailand.
Abstract
The purpose of this clinical study was to review experience in the management, and
outcome of eclamptic patients at Rajavithi Hospital. Standardized treatment for all cases of
eclampsia has consisted of magnesium sulfate intravenously and intramuscularly to control
convulsions by means of Chesley and Tepper's regimen, intravenous hydralazine intermittently
to lower diastolic blood pressure when it exceeds 110 mmHg, and initiation of delivery as soon
as the patient has regained consciousness and is stable. During a ten - year period there were
167,200 deliveries and 90 eclamptic patients, yielding an incidence of eclampsia of 1 in 1,857
deliveries. There were three maternal deaths (3.3%) due to intracerebral hemorrhage. Serious
adverse maternal outcomes were more frequent in women whose convulsions occurred before
delivery. Excluding postpartum cases, perinatal mortality of fetuses weighing 1,000 g or more
was 11.7 per cent.
Magnesium sulfate is the drug of choice for treatment of eclamptic convulsions. In
most situations, clinical assessment of deep tendon reflexes, respirations, and urine output is
adequate to monitor maternal magnesium toxicity without the need to determine actual
maternal serum magnesium levels.
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