A retrospective review of all cases of
eclampsia diagnosed at 3 obstetric teaching hospitals in Melbourne from January, 1978 to December, 1992 was undertaken. Ninety cases were identified; there were 5
maternal deaths and 17
perinatal deaths. Severe maternal morbidity such as pulmonary oedema,
acute renal failure or
HELLP syndrome was found in 26%. Significant maternal
thrombocytopenia (< 100 x 10(9)/L) was found in 50% and 35% had abnormal maternal liver function tests. Forty six women received
magnesium sulphate for treatment of
eclampsia and of these 3 had further
seizures compared to 4 of 18 who received
phenytoin (odds ratio 0.24 (0.04-1.52) X2, p = 0.09).
Eclampsia remains a significant complication of pregnancy with high maternal and perinatal mortality and morbidity. Results of this study show a trend that is in agreement with recent randomized controlled trials which demonstrate a reduced incidence of
seizures and maternal and fetal complications with the use of
magnesium sulphate. The results of these recent trials suggest that
magnesium sulphate should be the
drug of choice in the prevention and treatment of
eclampsia.