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Eclampsia (cont.)

What medications treat eclampsia?

Patient Comments

Once eclampsia develops, the only treatment is delivery of the baby (if eclampsia occurs prior to delivery). Eclampsia can develop following delivery, typically within the first 24 hours postpartum. Rarely, the onset of post-partum eclampsia can be delayed and occur up to one week following delivery. There is no cure for eclampsia other than the delivery of the infant.

Seizure treatment

  • Intravenous magnesium sulfate is the pharmacologic treatment of choice once a seizure occurs. This medication diminishes the chance of recurrent seizures. Magnesium treatment is continued for a total of 24 to 48 hours following the last recorded seizure. Patients may receive magnesium in an intensive care or high risk labor and delivery unit.  Close observation of the patient is mandatory while she is receiving magnesium sulfate.  During infusion of magnesium sulfate, the patient will be given supplemental intravenous fluids.  They will also require an in-dwelling urinary catheter in order to monitor urinary output.
  • Occasionally, seizures recur despite the utilization of intravenous magnesium sulfate.  In such cases, treatment with a short-acting barbiturate such as sodium amobarbital may be necessary to "break" or stop the seizure.  Other medications including diazepam (Valium) or phenytoin (Dilantin) may also be used.

Once the mother's condition is stabilized following a seizure, the physician will prepare for emergent delivery of the infant. This can occur by either cesarean section 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.

High blood pressure medication

  • Patients may require medication to treat high blood pressure during labor and/or after delivery. Hydralazine (Apersoline), labetalol (Normodyne, Trandate), and nifedipine are commonly used products to reduce blood pressure to systolic levels below 160 mm Hg. It is unusual to require medication for high blood pressure beyond six weeks post-partum unless the patient has a problem with hypertension that is unrelated to the pregnancy.

Medication to deliver the baby

The closer the patient is to her due date, the more likely her cervix will be favorable for delivery, and that induction of labor will be successful. Sometimes medications, such as oxytocin (Pitocin), are given to induce or shorten labor.

  • If the pregnancy is less than 34 weeks of gestational age, it is less likely that induction of labor will be successful (although induction is still possible). More commonly a Cesarean section will be necessary to forestall a bad outcome.
  • If the baby shows signs of compromise, such as decreased fetal heart rate, an immediate cesarean delivery should be performed.
  • Some patients may be given intramuscular steroids  to mature the fetal lungs if the fetal gestational age is less than 32 weeks.
Medically Reviewed by a Doctor on 10/11/2016

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