American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Oct 1991
Randomized Controlled Trial Clinical TrialMagnesium sulfate versus phenytoin for seizure prophylaxis in pregnancy-induced hypertension.
Seizure prophylaxis is standard intrapartum therapy for patients with pregnancy-induced hypertension. Magnesium sulfate is used in the United States in spite of limited literature comparing its efficacy with other anticonvulsants. Fifty patients with pregnancy-induced hypertension were prospectively randomized to receive magnesium sulfate or phenytoin for seizure prophylaxis. ⋯ Neither free phenytoin levels nor percentage of total phenytoin that was free correlated significantly with maternal albumin levels. The pharmacokinetics of phenytoin loading in the massively obese pregnant patient may differ and require further evaluation. Phenytoin is a well-tolerated alternative to magnesium sulfate for seizure prophylaxis in the patient with mild pregnancy-induced hypertension.
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Am. J. Obstet. Gynecol. · Oct 1991
Case ReportsReport of fourteen cases of nonimmune hydrops fetalis in association with hemorrhagic endovasculitis of the placenta.
Hemorrhagic endovasculitis of the placenta is a distinct vasodestructive process of unknown cause that has been associated with perinatal morbidity and mortality. A relationship between nonimmune hydrops fetalis and hemorrhagic endovasculitis has not been previously described. At a large teaching hospital, six cases of nonimmune hydrops fetalis were identified out of 72 cases of hemorrhagic endovasculitis over 6 years, for an incidence of 8%. ⋯ Eight additional cases of nonimmune hydrops fetalis were found among 2064 cases of hemorrhagic endovasculitis at the Michigan Placental Tissue Registry. In eight of the total 14 cases, after congenital malformations and cytomegalovirus infections were excluded, hemorrhagic endovasculitis was the only significant associated pathologic finding evident. The significance of the relationship between nonimmune hydrops fetalis and the vascular abnormalities of hemorrhagic endovasculitis remains to be determined.