Diazepam in Preeclamptic Toxaemia with Special Reference to its Effect on the Newborn Infant

Introduction Use has been made of the anticonvulsant properties of diazepam ('Valium') in the treatment of eclampsia (Gorbach, 1968; Pacelli et al., 1968; Lean et al., 19(8). Since the end of 1968 diazepam has been used for severe preeclampsia and eclampsia in the Department of Obstetrics at Northampton General Hospital. Patients with preeclampsia were given initially 20mg. of diazepam intravenously, plus hydrallazine (Apresoline') , which usually brought the patient under control. Sedation in the milder cases, after the initial response, was maintained with IOmg. of diazepam intramuscularly or orally. Prolonged high doses of diazepam were seldom necessary as the very severe cases warranted obstetrical interference. In patients with eclampsia, 40mg. of diazepam was given intravenously followed by an intravenous infusion containing 40mg. in 500ml. 5% dextrose. The rate of infusion varied with the patient's response but was usually 30 drops per minute. Intravenous hydrallazine was also given until the required hypotensive effect was obtajned, usually with a dose of 4 10mg. Frusemide, 40mg., was also given intravenously. Diazepam was found to be particularly useful in treating eclampsia occurring at home, before the patient's removal to hospital. It was noticed that some of the babies born to mothers who had been treated with diazepam were hypotonic and lethargic, and it was decided to investigate any possible connection. Ten mothers were given diazepam within 8 hours before delivery and a careful watch was kept on the state of the babies. The results