Arising from: Keller J et al. (2008) Nat Clin Pract Gastroenterol Hepatol 5: 430–443
I read with interest the article by Keller and colleagues on the spectrum and treatment of gastrointestinal disorders during pregnancy.1 The authors conclude in table 2 that treatment for eclampsia in the second or third trimester involves the administration of antihypertensive drugs and magnesium sulfate, I disagree. In my opinion, initial management of eclampsia should involve protection of the airway to minimize the risk of aspiration. It is my opinion I also believe that after the eclamptic seizure has ended, the appropriate treatment strategy should be termination of pregnancy. Moreover, hypertension is absent in 16 percent of women who develop eclampsia.2 The aim of using antihypertensive drugs and magnesium sulfate in this setting is to control blood pressure and prevent convulsion respectively, in order to prepare patients for delivery of the fetus.2,3
References
Keller J et al. (2008) The spectrum and treatment of gastrointestinal disorders during pregnancy. Nat Clin Pract Gastroenterol Hepatol 5: 430–443
Sibai BM (2005) Diagnosis, prevention, and management of eclampsia. Obstet Gynecol 105: 402–410
Leeman L and Fontaine P (2008) Hypertensive disorders of pregnancy. Am Fam Physician 78: 93–100
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Kittisupamongkol, W. Misconception of treatment for liver disease unique to pregnancy. Nat Rev Gastroenterol Hepatol 6, E7 (2009). https://doi.org/10.1038/ncpgasthep1369
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DOI: https://doi.org/10.1038/ncpgasthep1369
