Magnesium sulphate therapy in edampsia: an experience at Chanilka medical college Larkana

ABSTRACT

To evaluate the role of magnesium sulphate [MgSo4] in the management of eclamptic patients in terms of efficacy, safety, recurrence of convulsion and fetomaternal out come. This descriptive case series study was conducted over a period of one year from 1[st] October 2007 to 30[th] September 2008 at Gynae and Obs Unit-1 Sheikh Zayed Hospital for women CMC Larkana. All the patients admitted with eclampsia during the study period were included in the study. All patients were managed accordingly to the protocol. MgSO4 was given to eclamptic patients according to protocol who had no contra indications to this drug. Recurrence of convulsions, side effects of MgSO4, maternal and fetal outcome were noted. During the study period total no of obstetrical admissions were 4051 and total deliveries were 3200. Sixty seven patients presented with eclamptic fits which accounts for 1.6% of total deliveries. Only 13 patients [19.4%] were booked and the rest were un-booked. Majority was primigravida and common age group was 21-30 years. In the antepartum period eclampsia were accounted for 29.6%, intrapartum 43.6% while 26.8% were postpartum eclampsia. Fits occurred in the 3[rd] trimester after 32 weeks in 32 cases [58%]. All patients received MgSO4. 94% had no side effects, 2.9% developed diminished reflexes, 1.4% developed hypotension, 1.4% developed renal failure, recurrence of fits was observed in 4 cases [5.9%]. 3 patients were expired due to cardiopulmonary failure with in 24 hours after arrival at Hospital. Fetal out come was analyzed 48 retuses born alive, 4 were IUL 9.were FSB, and 4 were NND. In conclusion MgSO4 was found to be were effective and cheap for control of fits and has lower risk of recurrent convulsions. The occurrences of drug complications were very low with standard protocol. Maternal mortality was also 12w 2nd fetal outcome was found to be good. Clinical monitoring seems to be sufficient in this study