Modern management of eclampsia

Abstract

SummaryEclampsia, the occurrence of a seizure in association with preeclampsia, 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 ineVective. 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.

Critical pathways for the management of preeclampsia and severe preeclampsia in institutionalised health care settings

“…[18] The impact of providing poor health care ranges from worsening of the patient's clinical condition, [19] to high levels of maternal mortality. [20]…”

Strategies to prevent eclampsia in a developing country: II. Use of a maternal pictorial card

“…The more comprehensive program implemented elsewhere involving the training of health staff to identify, refer and treat women with pre-eclampsia however persisted five years after the intervention ceased [4]. Although the card is a useful tool, it is only part of a general arsenal of interventions, including training health care providers [5]. The card has been redesigned based on the inputs of the mothers (see Fig.…”

Eclampsia: an enigma

“…Despite eclampsia being recognised since antiquity, consistent management practices are still lacking in developing world. [10][11][12] Now a days, the physiopathology of eclampsia remains misunderstood. It is difficult to establish risk factors, the primipaternity being certainly one of these.…”