Disease relevance of Eclampsia

• The pathophysiological mechanisms and optimal treatment of preeclampsia and of eclampsia (excepting seizures) remain to be determined, as does the use of magnesium sulfate in this condition [1].
• Pending delivery, which is the only definitive therapy for preeclampsia, maternal complications of intracerebral hemorrhage and eclampsia may be prevented with judicious use of antihypertensive medication (e.g., hydralazine) and magnesium sulfate, respectively [2].
• REVIEW: Obstetric disorders causing coma and seizures include eclampsia, acute fatty liver of pregnancy, and amniotic fluid embolism [3].
• Malignant ventricular arrhythmias in eclampsia: a comparison of labetalol with dihydralazine [4].
• CONCLUSIONS: These data suggest that magnesium sulfate vasodilates the smaller-diameter intracranial vessels distal to the middle cerebral artery and may exert its main effect in the prophylaxis and treatment of eclampsia by relieving cerebral ischemia [5].

High impact information on Eclampsia

• These results validate the long-practiced use of magnesium sulfate in the prevention of eclampsia [6].
• Anticonvulsant prophylaxis with phenytoin for eclampsia has been recommended, but there are virtually no data to support its efficacy [6].
• INTERPRETATION: Magnesium sulphate halves the risk of eclampsia, and probably reduces the risk of maternal death [7].
• OBJECTIVE: Magnesium sulfate (MgSO4) is widely used for the treatment of eclampsia [8].
• The human endothelial cell nitric oxide synthase (eNOS) gene is a candidate for pre-eclampsia/eclampsia (PE/E) susceptibility [9].

Chemical compound and disease context of Eclampsia

• Hydralazine is the drug of choice for patients with eclampsia [10].
• Inhibition of the synthesis of prostaglandins prevented the hyporeactivity to isoproterenol during eclampsia [11].
• Diazepam was the preferred drug in eclampsia [12].
• Phenytoin sodium and magnesium sulphate in the management of eclampsia [13].
• The haemodynamic and respiratory effects of intravenous nimodipine used in the treatment of eclampsia [14].

Biological context of Eclampsia

• Magnesium sulfate is the drug of choice for reducing the rate of eclampsia developing intrapartum and immediately postpartum [15].
• Since 1955 standardized treatment applied uniformly to all cases of eclampsia at Parkland Memorial Hospital has consisted of (1) magnesium sulfate intravenously and intramuscularly to control convulsions, (2) intravenous hydralazine intermittently to lower diastolic blood pressure when it exceeded 110 mm [16].
• A woman at 32 weeks' gestation with eclampsia was given 120 mg diazepam shortly before emergency caesarean section [17].
• Neurologists have a specific role to play in the diagnosis and management of patients who have eclampsia, especially those who have recurrent seizures, raised intracranial pressure, and coma [18].
• CONCLUSION: There is an imbalance between lipid peroxidation and serum vitamin E levels in pre-eclampsia and eclampsia [19].

Anatomical context of Eclampsia

• Occipital lobe epilepsy: a chronic condition related to transient occipital lobe involvement in eclampsia [20].
• The use of nimodipine in a patient with eclampsia: color flow Doppler demonstration of retinal artery relaxation [21].
• Because of beneficial effects of magnesium in the therapy of motor disorders of the upper gastrointestinal tract and its sedative, anticonvulsive effect in eclampsia, we tested parenteral magnesium sulfate as a potential antiemetic in patients receiving cisplatin [22].
• RESULTS: Univariate analysis revealed statistical significance for the following variables associated with eclampsia: uric acid concentration, > 8.1 mg/dL; proteinuria (>3+); headache; visual symptoms; deep tendon reflexes >3+; serum albumin concentration, <3 mg/dL; and serum creatinine concentration, >1.3 mg/dL [23].
• Correlated plasma elastase and sera cytotoxicity in eclampsia. A possible role of endothelin-1 induced neutrophil activation in preeclampsia-eclampsia [24].

Gene context of Eclampsia

• CONCLUSION: Our data do not support a role for polymorphisms of the GSTM1 and GSTT1 genes in the pathogenesis of pre-eclampsia, eclampsia and HELLP syndrome [25].
• CONCLUSIONS: These results demonstrate that fibronectin may be a more valuable biomarker than thrombomodulin and PAI-1 for the assessment of endothelial damage in preeclampsia and eclampsia [26].
• OBJECTIVES: To investigate whether the serum concentrations of insulin, insulin-like growth factor-1 (IGF-1), and insulin-like growth factor binding protein-1 (IGFBP-1) were altered in women with mild pre-eclampsia, severe pre-eclampsia, and eclampsia [27].
• RESULTS: In pre-eclampsia/eclampsia, blood VCAM-1 and fibronectin levels were higher than in normal pregnancy [28].
• Thrombomodulin, plasminogen activator inhibitor type 1 (PAI-1) and fibronectin as biomarkers of endothelial damage in preeclampsia and eclampsia [26].

Analytical, diagnostic and therapeutic context of Eclampsia

• Metabolic clearance rate of dehydroisoandrosterone sulfate. VI. Studies of eclampsia [29].
• It is postulated that the poor performance of phenytoin as an anticonvulsant in severe eclampsia may relate to inadequate distribution of the drug to the brain as a result of cerebral oedema and poor cerebral perfusion rather than paradoxical seizure activity associated with high free phenytoin levels [30].
• STUDY DESIGN: The concentrations of plasma neuropeptide Y in pregnant patients with eclampsia (n = 8), preeclampsia (n = 8), and normotension (n = 8) were measured by radioimmunoassay on admission and 6 days after delivery [31].
• The single drug therapy of diazepam can be introduced to effectively control convulsions in eclampsia [32].
• It was concluded that though the ascorbic acid levels were normal in both the study and the control groups, erythrocyte fragility increased probably due to an elevation in peroxide and free radical levels in preeclampsia and eclampsia groups, but without any correlation with the severity of the clinical picture [33].

References