Dilantin as anticonvulsant in eclampsia.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Neurology

Background:

• Eclampsia, a severe complication of pregnancy characterized by seizures, poses a significant threat to maternal and fetal well-being.
• Despite advancements in medical care, eclampsia continues to be prevalent in certain regions, necessitating ongoing research into its management and outcomes.

Purpose of the Study:

• To evaluate current trends in eclampsia cases within a specific hospital setting.
• To assess the efficacy of phenytoin (Dilantin) as a primary anticonvulsant therapy for eclampsia.
• To identify risk factors and complications associated with eclampsia.

Main Methods:

• Retrospective analysis of 66 eclampsia cases managed between July 1997 and December 1998.
• Data collection included patient demographics, antenatal supervision, clinical presentation, treatment modalities, and maternal/perinatal outcomes.
• Treatment efficacy was evaluated based on seizure control, need for advanced respiratory support, and recurrence rates.

Main Results:

• The incidence of eclampsia was 1 in 139 deliveries (0.7%).
• A high proportion of patients (90.91%) lacked antenatal supervision, and 68.18% were primigravidae.
• Phenytoin monotherapy was used in 57.57% of cases, with a 40.91% recurrence rate; 13.64% required intubation.
• Maternal mortality was 4.56%, and perinatal mortality was 30.43%.

Conclusions:

• Eclampsia remains a prevalent condition in India with persistently high maternal and perinatal mortality rates.
• The study suggests a need to re-evaluate the efficacy of phenytoin as an anti-eclamptic agent, given the observed recurrence rates.
• Improving antenatal care and access to healthcare are crucial for reducing the burden of eclampsia.