Sibai B M
Department of Obstetrics and Gynecology, University of Tennessee, Memphis.
Am J Obstet Gynecol. 1990 Sep;163(3):1049-54; discussion 1054-5. doi: 10.1016/0002-9378(90)91123-t.
During a 12-year period, 254 cases of eclampsia were managed at this center. Eighty patients (32%) did not have edema, 58 (23%) had "relative hypertension," and 49 (19%) did not have proteinuria at the time of convulsions. Eclampsia developed at less than or equal to 20 weeks in 6 patients and beyond 48 hours post partum in 40 (16%). Convulsions developed in 33 while they were receiving standard doses of magnesium sulfate for preeclampsia during or after birth, and subsequent seizures developed in 36 (14%) after magnesium sulfate therapy was started. There was one maternal death (0.4%) and morbidity was frequent (acute renal failure, 4.7%; pulmonary edema, 4.3%; cardiorespiratory arrest, 3.1%; and aspiration, 2%. The use of multiple drug therapy was associated with significant maternal and neonatal complications. The total perinatal mortality was 11.8%, with the majority of them related to either abruptio placentae or extreme prematurity. These findings emphasize the need for intensive monitoring of women with preeclampsia throughout hospitalization and underscore the importance of maternal stabilization before and during transfer.
在12年期间，该中心共处理了254例子痫病例。80例患者（32%）无水肿，58例（23%）有“相对高血压”，49例（19%）抽搐发作时无蛋白尿。6例患者子痫发生在20周及以内，40例（16%）发生在产后48小时以后。33例患者在分娩期间或之后接受标准剂量硫酸镁治疗子痫前期时发生抽搐，36例（14%）在开始硫酸镁治疗后出现后续惊厥。有1例孕产妇死亡（0.4%），且并发症频发（急性肾衰竭，4.7%；肺水肿，4.3%；心肺骤停，3.1%；误吸，2%）。联合使用多种药物治疗与显著的孕产妇和新生儿并发症相关。围产期总死亡率为11.8%，其中大多数与胎盘早剥或极度早产有关。这些发现强调了在整个住院期间对先兆子痫妇女进行密切监测的必要性，并突出了在转运前和转运期间稳定孕产妇状况的重要性。
