Review
Management options
Modern management of
eclampsia
Osama Salha, James J Walker
Department of
Obstetrics and Gynaecology, St James's University Hospital, Leeds LS9
7TF, UK
Accepted 7 October
1998
Eclampsia, the occurrence of a seizure in association with
pre-eclampsia, remains an important cause of maternal mortality and
morbidity. Despite being recognised since antiquity, consistent management practices are still lacking. Given that the aim of good care
is to prevent seizures, it is disappointing that in the majority of
cases the first eclamptic convulsion occurs after admission to
hospital. This indicates that either the women who are likely to have a
convulsion were not identified accurately, or the treatment given was
ineffective. The answer to poor management of eclampsia lies in better
education and training of all obstetricians, anaesthetists, midwives,
and general practitioners in the diagnosis and treatment of severe
pre-eclampsia and eclampsia. Protocols for the management of fluid
balance, antihypertensive and anticonvulsant therapies should be
available and reviewed regularly. The universal adoption of such
guidelines in all obstetric units would substantially reduce elements
of substandard care which have repeatedly been identified in the
triennial reports of the confidential enquiries into maternal deaths in
the UK.
Keywords: pregnancy; hypertension; eclampsia
© 1999 by The Fellowship of Postgraduate Medicine
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