thiopental and Eclampsia

Eclampsia remains as a major obstetric problems that plagues a large percentage of women resulting in a large percentage of maternal and perinatal morbidities. In general, most women will have a classical presentation of preeclampsia. However, studies have suggested that some women will develop eclampsia without the classical findings.. We report a case of postpartum eclampsia with the first manifestation of convulsions resistant to diazepam and magnesium sulfate. In this patient high blood pressure was first detected after the seizures. Electroencephalography and CT scan of brain were normal. Patient's blood pressure returned to normal 1 month after parturition.. Postpartum eclampsia can manifest without a preceding preeclampsia phase. Therefore, eclampsia is not always preventable. Pregnancies complicated by eclampsia require a well-formulated management plan.

Topics: Adult; Anticonvulsants; Diagnosis, Differential; Eclampsia; Female; Humans; Hypertension, Pregnancy-Induced; Infant, Newborn; Postpartum Period; Pregnancy; Puerperal Disorders; Thiopental; Treatment Outcome

BACKGROUND Recurrent seizure in patients with magnesium sulfate-treated eclampsia is very rare and requires meticulous management due to poor prognosis. The development of eclamptic convulsions is considered a preventable obstetric situation. Magnesium sulfate has been the drug of choice in such cases. However, some cases are persistent and need more aggressive treatment. CASE REPORT First case: A 20-year-old, nulliparous woman was referred from a private midwifery practice with history of convulsion, 40 weeks of gestational age (GA), and in the active phase of labor. She had been treated with magnesium sulfate and nifedipine beforehand. Her fetus was tachycardic, so an emergency caesarean section was done and placental abruption was found. The day after the surgery, the patient had recurrent seizures despite receiving a maintenance dose of magnesium sulfate. The patient then received thiopental sodium and remained stable. Second case: A 19-year-old, nulliparous woman came to the hospital with 40 weeks of GA, prolonged premature rupture of the membrane (PROM), preeclampsia, and cephalopelvic disproportion (CPD). An emergency caesarean section was performed. Eighteen hours after surgery, the patient had convulsions despite receiving magnesium sulfate maintenance therapy. We repeated the loading dose of 2 g magnesium sulfate, but the seizures persisted. Hence, midazolam was given and the seizures remained controlled. Both babies were delivered without any significant complications. CONCLUSIONS We report 2 cases of GIP0-0 women with 40 weeks GA who had magnesium sulfate-resistant eclampsia and needed additional anticonvulsant drugs. These cases show the importance of comprehensive management and the need for alternative drugs in eclampsia.

Topics: Anticonvulsants; Cesarean Section; Drug Therapy, Combination; Eclampsia; Female; Humans; Magnesium Sulfate; Midazolam; Pregnancy; Recurrence; Seizures; Thiopental; Young Adult

Topics: Blood Pressure; Cerebrovascular Circulation; Cesarean Section; Dexamethasone; Dihydralazine; Dobutamine; Dopamine; Eclampsia; Electrolytes; Female; Heart; Humans; Intracranial Pressure; Nitroglycerin; Phenytoin; Pregnancy; Seizures; Serum Albumin; Thiopental

Topics: Adult; Anesthesia, Intravenous; Anesthesia, Obstetrical; Cerebral Hemorrhage; Cesarean Section; Eclampsia; Female; Humans; Obstetric Labor Complications; Oxygen Inhalation Therapy; Pregnancy; Succinylcholine; Thiopental

Topics: Adult; Anemia, Sickle Cell; Anesthesia, General; Anesthesia, Obstetrical; Cesarean Section; Chlormethiazole; Eclampsia; Female; Humans; Nitrous Oxide; Pregnancy; Pregnancy Complications, Hematologic; Thiopental

Topics: Eclampsia; Ethiopia; Female; Fetal Death; Humans; Maternal Mortality; Pregnancy; Thiopental

Topics: Acid-Base Equilibrium; Eclampsia; Female; Fetal Diseases; Humans; Maternal-Fetal Exchange; Pregnancy; Thiopental

Topics: Adult; Anemia, Hemolytic; Australia; Blood Chemical Analysis; Blood Platelet Disorders; Chlorpromazine; Diuresis; Eclampsia; Female; Fetal Death; Fetal Heart; Heart Rate; Hemoglobinuria; Hemolysis; Humans; Mannitol; Pregnancy; Pregnancy Complications, Hematologic; Promethazine; Seizures; Thiopental; Urinary Catheterization

Topics: Codeine; Eclampsia; Ergonovine; Female; Humans; Hyaluronoglucosaminidase; Magnesium Sulfate; Meperidine; Morphine; Paraldehyde; Phenobarbital; Pregnancy; Thiopental

Topics: Eclampsia; Female; Hospitals, General; Infant Mortality; Netherlands; Pregnancy; Pregnancy Complications; Statistics as Topic; Thiopental

Topics: Eclampsia; Ethanol; Female; Phenothiazines; Pregnancy; Thiopental

Topics: Barbiturates; Eclampsia; Female; Humans; Pregnancy; Seizures; Sodium; Thiopental

Topics: Barbiturates; Eclampsia; Female; Humans; Pregnancy; Seizures; Sodium; Thiopental

Topics: Barbiturates; Eclampsia; Female; Humans; Pregnancy; Seizures; Thiopental

Topics: Barbiturates; Eclampsia; Female; Humans; Pregnancy; Sodium; Thiopental

Topics: Barbiturates; Eclampsia; Female; Pregnancy; Sodium; Thiopental

Topics: Barbital; Eclampsia; Female; Glucose; Pregnancy; Seizures; Sodium; Sodium Chloride; Sodium Chloride, Dietary; Thiopental

Topics: Eclampsia; Female; Pregnancy; Seizures; Thiopental