Use of single dose prophylactic magnesium sulphate in severe preeclampsia in preventing seizures

Shobha Bembalgi, Preet Kanwal


Background: Preeclampsia is a pregnancy specific multi organ disease process characterized by de novo development of hypertension and proteinuria after 20 weeks of gestation. Preeclampsia complicates 2-8% of pregnancies.

Methods: We have studied 100 patients with severe preeclampsia who were randomly divided into two groups. One group received 4 gm intravenous MgSO4 on admission which was prepared by diluting in 10 ml normal saline and was given over 10-12 minutes slowly with strict monitoring. 50 patients of severe pre-eclampsia with B.P>160/110 mm of Hg were given the prophylactic dose and rest 50 acted as controls. Monitoring of B.P., urine output; respiratory rate and FHS was done.

Results: We have 1 case of seizure after 8 hours of giving loading dose, which was changed to Pritchard’s regimen for further management whereas 7 patients had in the control groups. There were no cases of magnesium toxicity seen. There were no cases of maternal deaths and postpartum convulsions.

Conclusions: Single loading dose of magnesium sulphate is an efficient prophylactic in preventing eclampsia.


Preeclampsia, Pregnancies, Monitoring

Full Text:



Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics 24th edition, McGraw-Hill Companies, Inc; 2014.

Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367:1066.

The eclampsia trial collaborative group. Which anticonvulsant for women with eclampsia? Evidence from the collaborative eclampsia trial. Lancet. 1995;345:1455-63.

Pritchard JA. The use of magnesium ion in the management of eclamptogenictoxemias. Surg Gynecol Obstet. 1955;100(2):131-40.

The magpie trial collaborative group. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The magpie trial: a randomised placebo- controlled trial. Lancet. 2002;359:1877-90.

Begum MR, Begum A, Quadir E. Loading dose versus standard regime of magnesium sulphate in the management of eclampsia: a randomized trial. Obstet Gynaecol. 2002;28:154-9.

Suman S, Shinanjalin M, Ajit P, Uday P. Low dose magnesium sulphate therapy for eclampsia and imminent eclampsia: regimen tailored for Indian women. J Obstet Gynecol Indi. 2003;55:546-50.

Hypertension in pregnancy. American college of Obstetrics and Gynaecology (2013b) Criteria for severe preeclampsia; 2013.

Coetzee EJ, Dommisse J, Anthony J. A randomized controlled trial of intravenous magnesium sulphate versus placebo in the management of women with severe pre­eclampsia. An International Journal of Obstetrics and Gynaecology. 1998;105(3):300-3.

Ranganna H, Saha SC, Thami MR, Kumar P. Prophylactic magnesium sulphate in severe preeclampsia- loading dose only versus conventional 24 hours therapy of modified Pritchard's regime: a randomized trial. IOSR Journal Of Pharmacy. 2014;4(6):39-47.

Shah R, Mehendale SS. 4 gm intravenous magnesium sulphate in severe preeclampsia for prevention of eclamspia. Indian Journal of Applied Research. 2014;4(3):422-3.

Belfort MA, Anthony J, Saade GR, Allen JC. A comparison of magnesium sulfate and nimodipine for the prevention of eclampsia. N Eng J Med. 2003;348:304-11.