Phenytoin Archives - Revista Brasileira de Ginecologia e Obstetrícia

Purpose: to compare the efficiency between magnesium sulfate and phenytoin in the control of convulsions in patients with eclampsia and to evaluate the effects of magnesium sulfate and phenytoin on the maternal and perinatal prognosis in patients with eclampsia. Methods: this is a prospective, randomized and controlled study in which the results obtained with the use of anticonvulsive treatment in 77 women with eclampsia, treated with either magnesium sulfate or phenytoin, were analyzed comparatively. The drugs which were used in both therapeutic schemes were distributed in a one to one ratio, in randomly numbered boxes which presented similar characteristics. When a patient was admitted, a box was opened and its contents were given to the patient. Results: in the group whose patients were treated with magnesium sulfate, 19.5% had recurrent convulsions while in the group whose patients used phenytoin, 36.1% had new crises (p<0,05). The patients who were treated with magnesium sulfate showed a greater prevalence of postpartum hemorrhage (14,7%) than those to whom phenytoin was administered (2.7%) (p<0.05). In relation to the newborns, 17.0% of the group from mothers treated with magnesium sulfate presented respiratory distress as opposed to the group of newborns from mothers treated with phenytoin (11.8%), (p> 0,05). Conclusion: magnesium sulfate is shown to be more efficient than phenytoin in the control and the prevention of convulsions in patients with eclampsia. However, its utilization showed a higher prevalence of postpartum hemorrhage and respiratory distress. Phenytoin should be used in cases where the use of magnesium sulfate is contraindicated.