RESUMEN
To determine the efficacy and safety of 12 hour magnesium sulphate maintenance therapy in management of severe pre eclampsia by comparing it with 24 hours standard magnesium sulphate maintenance therapy. Randomized control trial. MCH Centre PIMS from November 2011 to April 2012. All patients with severe preeclampsia [blood pressure of 160/110 mm of Hg or more, proteinuria 2+ on dipstick] or signs and symptoms of impending eclampsia were included in the study. After receiving the loading dose, patients were randomly assigned to 12 hours maintenance therapy of magnesium sulphate in group A versus 24 hours therapy in group B.The main Outcomes measures included: frequency of occurrence of fits, side effects of magnesium sulphate [major and minor], degree of rise in serum uric acid, SGOT and proteinuria, maternal complications and neonatal outcomes. Of 104 patients 52 patients were assigned to each group. Both groups were comparable with regards to maternal age, parity and gestational age. In group A [12 hours regimen] had higher baseline levels of S.uricacid, SGOT, proteinuria versus 24 hours of administration of magnesium sulphate [p=0.15]. Regarding outcome, none of patients in either group had eclamptic fit, conveying that 12 hour magnesium sulphate therapy was equally effective in term of prevention of eclampsia as 24 hours magnesium sulphate therapy. On the other hand group B had significantly higher frequency of minor side effects of magnesium sulphate [nausea, flushing] [p=0.09], compared with 12hours regime. No difference was found among 2 groups in terms of major side effects of magnesium sulphate [respiratory depression, renal failure],occurrence of eclamptic fits, maternal complications and neonatal outcomes. 12 hours maintenance therapy is equally effective in prophylaxis of eclamptic fits and maternal complications, as 24 hours maintenance therapy in patients with severe pre eclampsia and is associated with lesser side effects than 24 hours regime. Large scale studies are however required for generalization of results.
RESUMEN
To evalmicroate the effects of oral zinc smicropplementation on the sermicrom zinc levels of pregnant women. Experimental [domicroble blinded randomized controlled trial]. PIMS and KRL Hospital, Islamabad, and commmicronity in tehsil Kahmicrota from April 2003 to April 2004. Pregnant women of 10 to 16 weeks gestation were invited to enter the stmicrody on their booking visit. A sample size of 125 in each gromicrop was calcmicrolated. After taking an informed consent, they were assigned to control or test gromicrop by simple random sampling techniqmicroe. A detailed qmicroestionnaire was filled-microp by trained staff and initial evalmicroation along with sermicrom zinc samples was collected. The smicrobjects were given either zinc smicrolphate powder, eqmicroivalent to 20 mg elemental zinc, or were given placebo treatment along with romicrotine smicropplements. These patients were followed microp thromicroghomicrot the pregnancy by health care providers and their compliance was monitored. At delivery, sermicrom samples were again collected for zinc estimation. The data was entered on compmicroter, cleaned and analyzed. Paired t-test was microsed for comparison of means. The data of 242 smicrobjects was analyzed at the end of the stmicrody. The mean age of the stmicrody participants was 25.7 +/- 4.8 years [range 16 to 40]. Both the gromicrops were similar in other demographic variables as socioeconomic statmicros, edmicrocation, BMI, height and weight. One-third of the patients had sermicrom zinc levels below 64microg/dl at the start of the stmicrody. A 128 pairs of pre and post-sermicrom zinc levels were analyzed in the two gromicrops [64 pairs in each gromicrop] to compare the means. The zinc smicropplemented women showed a mean increase of 14.7 microg/dl [95% CI 5-23] [P=0.002]. On the other hand the non-smicropplemented gromicrop showed an actmicroal decrease in the sermicrom zinc level which, however, did not reach statistical significance [P=0.47]. Oral zinc smicropplementation of pregnant women with 20 mg elemental zinc was effective in raising the sermicrom levels of zinc. It is smicroggested that smicropplementation trials with larger dose of zinc shomicrold be carried omicrot