Abstract | OBJECTIVES: DESIGN: Prospective descriptive study. SETTING: Labour Ward, King Edward VIII Hospital, Durban, South Africa. Tertiary referral centre serving an underprivileged community. SUBJECTS: MAIN OUTCOME MEASURES: RESULTS: Although total phenytoin levels were within the therapeutic range, free phenytoin levels were abnormally high in all patients. Three patients (2 with eclampsia and 1 with imminent eclampsia) each had a seizure after phenytoin treatment had been initiated. CONCLUSION: Neither total nor free phenytoin levels were good predictors of seizure control. It is postulated that the poor performance of phenytoin as an anticonvulsant in severe eclampsia may relate to inadequate distribution of the drug to the brain as a result of cerebral oedema and poor cerebral perfusion rather than paradoxical seizure activity associated with high free phenytoin levels.
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Authors | S Naidu, J Moodley, J Botha, L McFadyen |
Journal | British journal of obstetrics and gynaecology
(Br J Obstet Gynaecol)
Vol. 99
Issue 11
Pg. 881-6
(Nov 1992)
ISSN: 0306-5456 [Print] England |
PMID | 1450135
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Dose-Response Relationship, Drug
- Eclampsia
(blood, drug therapy)
- Female
- Humans
- Phenytoin
(adverse effects, blood, therapeutic use)
- Pre-Eclampsia
(blood, drug therapy)
- Pregnancy
- Pregnancy Outcome
- Prospective Studies
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