Presentation and management of eclampsia.

Three hundred forty-seven cases of eclampsia were managed at the University College Hospital (UCH), Ibadan, Nigeria from 1977 to 1986 (9.3 per 1000 deliveries). Thirty-one percent of seizures occurred antenatally, 46.2% during labor and 23.2% postnatally. Only 5% first occurred in the hospital. Seizures were controlled with diazepam, lytic cocktail (chlorpromazine, pethidine and phenergan), sodium amylobarbitone, paraldehyde and bromethol. Maternal mortality was 2.9%, and perinatal mortality 193 per 1000, respectively. Prevention of avoidable factors (absent or poor antenatal care and prolonged labor) by the provision of comprehensive antenatal care will reduce the incidence of eclampsia. Improvement in management facilities prior to transfer to referral centers, the use of magnesium sulfate or diazepam to control seizures and the avoidance of hypotonic solutions and 50% glucose during therapy will reduce morbidity and mortality.