A REVIEW OF ECLAMPSIA IN MELBOURNE - 1978-1992

A retrospective review of all cases of eclampsia diagnosed at 3 obstet ric teaching hospitals in Melbourne from January, 1978 to December, 19 92 was undertaken. Ninety cases were identified; there were 5 maternal deaths and 17 perinatal deaths. Severe maternal morbidity such as pul monary oedema, acute renal failure or HELLP syndrome was found in 26%. Significant maternal thrombocytopenia (<100 x 10(9)/L) was found in 5 0% and 35% had abnormal maternal liver function tests. Forty six women received magnesium sulphate for treatment of eclampsia and of these 3 had further seizures compared to 4 of 18 who received phenytoin (odds ratio 0.24 (0.04-1.52) X(2), p=0.09). Eclampsia remains a significant complication of pregnancy with high maternal and perinatal mortality and morbidity. Results of this study show a trend that is in agreement with recent randomized controlled trials which demonstrate a reduced incidence of seizures and maternal and fetal complications with the us e of magnesium sulphate. The results of these recent trials suggest th at magnesium sulphate should be the drug of choice in the prevention a nd treatment of eclampsia.