Clin Obstet Gynaecol. 1982 Dec;9(3):711-21.


PIP: The perceptive physician can anticipate and prevent eclampsia. If possible, he should try to prolong preeclamptic pregnancies to the 37th week to avoid neonatal deaths from complications and prematurity. In some cases, preeclampsia strikes and progresses rapidly before the 30th week, however, and, in order to save the mother, the pregnancy must be terminated. If the preeclamptic woman deteriorates to the point where severe headache, epigastric pain, vomiting, and hyperreflexia exist, eclampsia is imminent. If she becomes eclamptic, clinicians must immediately begin to manage the convulsions with a sedative. Diazepam has proved successful which accounts for its widespread use in Great Britain and developing countries. Large doses given over a long period of time, however, adversely affect the newborn, e.g. respiratory depression. Another popular sedative is magnesium sulphate (in use for 50 years). Dangers of overdose can be avoided by testing the patella reflex every hour when magnesium sulphate is being administered intravenously: the reflex becomes null before serious toxic effects occur. If the systolic blood pressure exceeds 170mmHg, antihypertensives should also be given selectively to prevent cerebral hemorrhage. The preferred antihypertensive must act rapidly and predictably, with a wide margin of safety between the therapeutic and toxic dose. Hydralazine hydrochloride meets these requirements. Fluid and acid-base balances must be controlled to treat hypovolemia, oliguria, and acidosis. The longer delivery is delayed, the worse the outlook for mother and infant. Regardless of the type of delivery, clinicians must avoid hemorrhage and operative shock because eclamptics cannot tolerate blood loss. It is imperative that clinicians do not become so involved in saving the patient that they overtreat her, e.g., mixing antihypertensives.

Publication types

  • Review

MeSH terms

  • Abruptio Placentae / therapy
  • Acid-Base Equilibrium
  • Barbiturates / therapeutic use
  • Benzodiazepines / therapeutic use
  • Coma / therapy
  • Delivery, Obstetric / methods
  • Eclampsia / complications
  • Eclampsia / therapy*
  • Female
  • Heart Failure / therapy
  • Humans
  • Hypertension / drug therapy
  • Kidney Diseases / therapy
  • Magnesium Sulfate / therapeutic use
  • Paraldehyde / therapeutic use
  • Pregnancy
  • Seizures / drug therapy
  • Water-Electrolyte Balance


  • Barbiturates
  • Benzodiazepines
  • Magnesium Sulfate
  • Paraldehyde