| Diagnosis, prevention, and management of eclampsia. | |
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MedLine Citation:
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PMID: 15684172 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The pathogenesis of eclamptic convulsions remains unknown. Cerebral imaging suggests that cerebral abnormalities in eclampsia (mostly vasogenic edema) are similar to those found in hypertensive encephalopathy. However, cerebral imaging is not necessary for the diagnosis or management of most women with eclampsia. The onset of eclamptic convulsions can be antepartum (38-53%), intrapartum (18-36%), or postpartum (11-44%). Recent data reveal an increase in the proportion of women who develop eclampsia beyond 48 hours after delivery. Other than early detection of preeclampsia, there are no reliable tests or symptoms for predicting the development of eclampsia. In developed countries, the majority of cases reported in recent series are considered unpreventable. Magnesium sulfate is the drug of choice for reducing the rate of eclampsia developing intrapartum and immediately postpartum. There are 4 large randomized trials comparing magnesium sulfate with no treatment or placebo in patients with severe preeclampsia. The rate of eclampsia was significantly lower in those assigned to magnesium sulfate (0.6% versus 2.0%, relative risk 0.39, 95% confidence interval 0.28-0.55). Thus, the number of women needed to treat to prevent one case of eclampsia is 71. Magnesium sulfate is the drug of choice to prevent recurrent convulsions in eclampsia. The development of eclampsia is associated with increased risk of adverse outcome for both mother and fetus, particularly in the developing nations. Pregnancies complicated by eclampsia require a well-formulated management plan. Women with a history of eclampsia are at increased risk of eclampsia (1-2%) and preeclampsia (22-35%) in subsequent pregnancies. Recommendations for diagnosis, prevention, management, and counseling of these women are provided based on results of recent studies and my own clinical experience. |
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Authors:
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Baha M Sibai |
Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 105 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 2005 Feb |
Date Detail:
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Created Date: 2005-02-01 Completed Date: 2005-03-10 Revised Date: 2009-10-26 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 402-10 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267, USA. baha.sibai@uc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anticonvulsants Antihypertensive Agents / therapeutic use Combined Modality Therapy Eclampsia / diagnosis*, mortality, prevention & control, therapy* Female Gestational Age Humans Hypertension / drug therapy Maternal Age Postpartum Period Pre-Eclampsia / diagnosis*, mortality, prevention & control, therapy* Pregnancy Pregnancy Outcome* Prenatal Diagnosis / methods Primary Prevention / methods Prognosis Recurrence / prevention & control Risk Assessment Seizures / drug therapy Severity of Illness Index Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anticonvulsants; 0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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