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Dilantin as anticonvulsant in eclampsia.

Abstract
Sixty-six cases of eclampsia amongst 9178 deliveries were managed from July, 1997 to December, 1998 in the department of obstetrics and gynaecology at UCMS & GTB Hospital, Delhi. The aim was to evaluate the changing trends in patients of eclampsia and to assess the efficacy of dilantin in its treatment. The incidence recorded was 1 in 139 deliveries (0.7%). Majority (90.91%) were unsupervised in antenatal period and 68.18% were primigravidae. Eclampsia developed at < 28 weeks of pregnancy in 3.03% of patients. All the patients had hypertension and proteinuria at the time of admission and 51.52% showed hypertensive changes on fundus examination. While single anticonvulsant therapy in the form of dilantin was used to manage 57.57% of patients, 13.64% required intubation and positive pressure ventilation. Fit recurrence on treatment was noticed in 40.91% of patients. Lower segment caesarean section was conducted in 18.18% of patients. Three maternal deaths (4.56%) attributed to ventricular tachycardia, aspiration and intracerebral haemorrhage were recorded. Morbidity was frequent in the form of status eclampticus (n = 5), postpartum psychosis (n = 5), retinal detachment (n = 1), coagulation abnormality (n = 11). The perinatal mortality rate was 30.43%. The study concludes that eclampsia is still rampant in India and despite better medical facilities, maternal and perinatal mortality remains high. The efficacy of dilantin as anti-eclamptic needs to be reviewed.
AuthorsSonal Bathla, Amita Suneja, Kiran Guleria, Neera Agarwal
JournalJournal of the Indian Medical Association (J Indian Med Assoc) Vol. 100 Issue 9 Pg. 561-4 (Sep 2002) ISSN: 0019-5847 [Print] India
PMID12455387 (Publication Type: Evaluation Study, Journal Article)
Chemical References
  • Anticonvulsants
  • Antihypertensive Agents
  • Phenytoin
Topics
  • Adolescent
  • Adult
  • Anticonvulsants (therapeutic use)
  • Antihypertensive Agents (therapeutic use)
  • Delivery, Obstetric (methods)
  • Eclampsia (drug therapy, epidemiology, therapy)
  • Female
  • Humans
  • Infant Mortality
  • Infant, Newborn
  • Phenytoin (therapeutic use)
  • Positive-Pressure Respiration
  • Pregnancy
  • Retrospective Studies
  • Treatment Outcome

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