Magnesium sulphate therapy in pre-eclampsia and eclampsia: one year experience

ABSTRACT

To study the efficacy of Magnesium Sulphate Therapy for prevention and control of fits in patients with preeclampsia and eclampsia. Interventional Study. This study was conducted at the Department of Obstetric and Gynecology Unit II, Mother and Child Health Centre, Pakistan Institute of Medical Sciences, Islamabad from April 2002 to March 2003. Total 50 women with preeclampsia / imminent eclampsia and eclampsia fulfilling the study criteria were admitted in HAD, adjacent to labour ward. Magnesium Sulphate therapy started after complete evaluation of the patients according to the study protocol. Patients monitored carefully for any side effects of magnesium therapy and occurrence of convulsions. Primary outcome measures were development of eclampsia or recurrent seizures in patients with eclampsia, neonatal morbidity and mortality. Secondary outcome measures were serious maternal morbidity, magnesium toxicity and other side effects of MgSO[4] and complications of labour and delivery. Total 50 women were entered into the study over a period of one year. Out of these 12 [24%] women presented with eclampsia, 5 [10%] had imminent eclampsia and 33 [66%] were diagnosed as pre-eclampsia. Of the 12 women with eclampsia, none had recurrent seizures. Out of 38 women with pre-eclampsia and imminent eclampsia, only one [2%] woman developed eclampsia. There was no case of magnesium toxicity. Overall 12 [24%] of the babies were delivered with poor Apgar score. Two babies were expired within five minutes of delivery while 5 babies expired in NICU. There were 6 intrauterine deaths and 4 intrapartum deaths. Magnesium sulphate is an effective anticonvulsant for the treatment and prevention of eclampsia when used judiciously. In the dosage used it does not have any substantive harmful effects on women and their babiesstage repair is more appropriate with satisfactory results: