title: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University College of Medical Sciences & GTB Hospital, Delhi 110095.
authors.forename: Sonal
authors.initials: S
authors.lastname: Bathla
authors.forename: Amita
authors.initials: A
authors.lastname: Suneja
authors.forename: Kiran
authors.initials: K
authors.lastname: Guleria
authors.forename: Neera
authors.initials: N
authors.lastname: Agarwal
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D036861:Delivery, Obstetric / Q000379:methods; D004461:Eclampsia / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D010672:Phenytoin / Q000627:therapeutic use*; D011175:Positive-Pressure Respiration; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000959:Antihypertensive Agents; D010672:Phenytoin