Seizure prophylaxis

It is not possible to predict reliably which women with pre-eclampsia will develop eclampsia. Therefore the decision to administer seizure prophylaxis in women with pre-eclampsia is a balance between the small risk of eclampsia and the risks of anticonvulsant treatment. One study comparing magnesium and phenytoin in women with pre-eclampsia suggested that fewer women treated with magnesium sulfate developed eclamptic seizures ( Lucas,,et ai 1995). However, the value of routine seizure prophylaxis has been questioned by numerous studies which have shown very low seizure rates in women with severe pre-eclampsia managed expectantly. No randomized trial has compared seizure rates in women managed with and without anticonvulsant therapy. Therefore, if seizure prophylaxis is deemed appropriate, magnesium sulfate is probably the drug of choice.

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