Prevention and management of eclampsia
Eclampsia is a pregnancy-specific multisystem disorder associated with substantial fetomaternal morbidity and mortality [1–6]. The incidence of eclampsia is variable, but is generally low in well-resourced regions compared with resource-deficient countries. However, once eclampsia ensues the potential for both morbidity (immediate and long term) and mortality is cause for equal concern. In the context of its elusive aetiology, the prevention and management of this multiorgan disease challenge even the most experienced of clinicians. This paper focuses on the definition of pre-eclampsia/eclampsia, the suggested pathophysiology of the disease, current potential preventative strategies and specific issues of concern in the management of the critically ill eclamptic patient.
KeywordsSystemic Inflammatory Response Syndrome Cerebral Perfusion Pressure Glasgow Coma Score Magnesium Sulphate Hypertensive Encephalopathy
Unable to display preview. Download preview PDF.
- 2.Lewis G (ed) (2001) Why mothers die 1997–1999. The fifth report on the confidential enquiries into maternal deaths in the United Kingdom. RCOG Press, LondonGoogle Scholar
- 5.Paruk F, Moodley J (2003) Eclampsia: a prospective audit of 112 patients admitted to King Edward VIII Hospital Obstetric High Care Unit (in press)Google Scholar
- 8.Friedman SA, Taylor RN, Roberts JM (1991) Pathophysiology of pre eclampsia. Clin Perinat 18: 661–682Google Scholar
- 15.Olsen S, Secher NJ, Tabor A et al (2000) Randomised clinical trials of fish oil supplementation in high risk pregnancies. Br J Obstet Gynaecol 107: 382–395Google Scholar
- 16.Leitch CR, Cameron AD, Walker JJ (1998) The changing pattern of eclampsia over a 60 year period. Br J Obstet Gynaecol 104: 917–922Google Scholar
- 18.South African Magpie Trial Collaborative Group (2003) The Magpie study-clinical implications for poor countries. S Afr Med J 93: 264–265Google Scholar
- 22.Paruk F, Moodley J (2000) Treatment of severe pre eclampsia/eclampsia syndrome. In: Studd J (ed) Progress in Obstetrics and Gynecology. 14: 103–119Google Scholar
- 32.Harris CM, Foley M (2002) Critical care obstetrics: 13 years of experience in a community practice setting. Obstet Gynecol 99 Suppl 1: S79Google Scholar
- 42.The Eclampsia Trial Collaborative Group (1995) Which anticonvulsant for women with eclampsia? Evidence from the Eclampsia Collaborative Trial. Lancet 345: 1455–1563Google Scholar