Articles  |   February 2017
ACE Question
Article Information
Education / CPD / Obstetric Anesthesia / Articles
Articles   |   February 2017
ACE Question
ASA Monitor 02 2017, Vol.81, 58.
ASA Monitor 02 2017, Vol.81, 58.
A 23-year-old woman underwent cesarean delivery at 34 weeks’ gestation because of severe preeclampsia. Nearly 72 hours after delivery, she experiences a generalized tonic–clonic seizure. Which of the following anticonvulsants is most appropriate?
Eclampsia is described as seizures or coma occurring in the presence of preeclampsia and in the absence of any other neurologic pathology or other causative factors. It occurs in 0.1 to 5.5 of every 10,000 pregnancies in Western countries and has been associated with a maternal mortality rate of approximately 2 percent. A majority of patients with eclampsia have an established diagnosis of preeclampsia before the onset of seizures; however, in approximately a third of patients with eclampsia, the seizure is the initial presentation. The severity of hypertension does not reliably predict the risk of developing eclampsia. Eclamptic seizures are tonic–clonic in nature, typically self-limiting and of short duration, and do not usually recur. For the majority of these patients, the initial seizure occurs during labor or within the first 48 hours after delivery. Late eclampsia is defined as new onset seizures occurring from 48 hours after delivery to less than four weeks postpartum.
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