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Medical Author:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Once eclampsia develops, the only treatment is delivery of the baby (if eclampsia occurs prior to delivery). Eclampsia can also occur after delivery (up to 24 hours postpartum, typically). Rarely, eclampsia can be delayed and occur up to one week following delivery. There is no cure for eclampsia.

Magnesium sulfate (given intravenously) is the treatment of choice once eclampsia develops. This treatment decreases the chances of having recurrent seizures. Magnesium treatment is continued for a total of 24 to 48 hours after the last seizure. Patients may receive magnesium in an intensive care unit or a labor and delivery unit. While magnesium is given they will be observed closely, receive intravenous fluids, and have a Foley catheter placed in the bladder (to measure urine output).

Occasionally, recurrent seizures require additional treatment with a short-acting barbiturate such as sodium amobarbital. Other medications including diazepam (Valium) or phenytoin (Dilantin) have been used to treat eclampsia; however, they are not as effective as magnesium sulfate.

Patients may also receive treatment for elevated blood pressure while being treated for eclampsia. Common blood pressure medications (for women with eclampsia) include hydralazine (Apresoline) or labetalol (Normodyne, Trandate).

Once the mother's condition is stabilized following a seizure, the doctor will prepare to deliver the baby. This can occur either by cesarean delivery or induction of labor and vaginal delivery. If the patient is already in labor, labor can be allowed to progress provided there is no evidence that the baby has become "distressed" or compromised by the seizure.

The closer the person is to the due date, the more likely the cervix will be ripe (ready for delivery), and that induction of labor will be successful. Sometimes medications, such as oxytocin (Pitocin), are given to help induce labor.

• The earlier in pregnancy (24 to 34 weeks), the less chance of a successful induction (although induction is still possible). It is more common to have a cesarean delivery when eclampsia necessitates delivery early in pregnancy.
• If the baby shows signs of compromise, such as decreased fetal heart rate, an immediate cesarean delivery will be performed.

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