Conservative management of pre-eclamptic and eclamptic patients: a re-evaluation.
A philosophy of conservatism in regard to termination of gestations complicated by pregnancy-induced hypertension has been practiced at the University of Virginia Hospital for many years. The advent of improved methods to evaluate the intrauterine fetal status prompted retrospective review of 246 pre-eclamptic and 13 eclamptic patients managed during the antepartum period. Continuous magnesium sulfate infusion for periods up to 144 hours (265 grams) was the therapeutic measure used for prevention or control of convulsions. Average duration of predelivery hospitalization increased 8.7 days, and the incidence of neonates requiring intensive care increased 10.9% with the use of tests to evaluate intrauterine fetal status. Frequency of spontaneous onset of labor and vaginal delivery decreased 18.6%. The uncorrected perinatal mortality rate for all antepartum patients was 7.0%. The mortality rate for infants of mothers with superimposed, severe or convulsive disease was significantly less in pregnancies in which tests of fetoplacental status were employed (8.2%) compared to pregnancies in which they were not (15.2%). The only maternal death was a 41-year-old patient with severe pre-eclampus who suffered a cerebral vascular accident on the fifth hospital day. These data reiterate the value of conservative management with meticulous individualized care.
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods; D004461:Eclampsia / Q000401:mortality / Q000628:therapy*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007751:Labor, Induced; D007743:Labor, Obstetric; D007902:Length of Stay; D008278:Magnesium Sulfate / Q000627:therapeutic use; D010925:Placental Function Tests; D011225:Pre-Eclampsia / Q000401:mortality / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D012640:Seizures / Q000517:prevention & control; D014768:Virginia
D008278:Magnesium Sulfate