Comparison of low dose Dhaka regimen of magnesium sulphate with standard pritchard regimen in eclampsia

Anshu Sharma, Kumud Bala Gupta, Aruna Nigam, Kushla Pathania


Background: The purpose of this study was to determine the effects of altitude on severe preeclampsia and eclampsia and subsequent perinatal outcome.

Methods: This prospective study was carried out during 1st March 2011 to 29th February 2012 in Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla situated at a height of 2200m from sea level. All the subjects with severe preeclampsia or eclampsia were included in the study and their perinatal outcome was noted.

Results: There were a total of 5897 deliveries. There were 423 cases of PIH making an incidence of severe preeclampsia and eclampsia 15.4% and 7.3% among PIH, respectively. Majority of cases (60.4%) belonged to age group 18-25 year with mean systolic blood pressure in eclampsia was 184.3±18.6 mm of Hg and in severe preeclampsia was 171.5±13.9 mm of Hg. Mean diastolic blood pressure was 125.8±12.6 mm of Hg in eclampsia and 118.6±4.3 mm of Hg in severe preeclampsia. Various other complications in eclampsia and severe preeclampsia cases included IUGR (35.1%) cases, abruptio placentae (15.9%), HELLP syndrome (9.6%) cases, spontaneous preterm labour (21.3%) and intrauterine death (6.4%). Live births were 85.1%; fresh still births were 8.5%. Mean birth weight was 2192.5±572grams. Respiratory distress syndrome was seen in 21.3% neonates, Hyperbilirubinemia was seen in 26.2% neonates intracranial bleeding was seen in 7.5% neonates. Perinatal mortality was 27.7% which constitute14.9% still birth neonatal deaths.

Conclusions: Efficacy of MgSO4 in prevention and treatment of eclamptic convulsions is time tested and supported with a variety of studies. Since its narrow therapeutic and toxicity is major concern, the use of low dose MgSO4 protocols is a viable alternative to standard dose therapy. However, because of small study design further studies on the larger scale are required to support routine clinical use of low dose protocols.


Eclampsia, Magnesium sulphate, Preeclampsia

Full Text:



Tukur J. The use of magnesium sulphate for the treatment of severe preeclampsia and eclampsia. Annals of African Medicine 2009; 8(2): 76-80.

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

Seth S, Nagrath A, Singh DK. Comparison of low dose, single dose, and standard Pritchard regimen of magnesium sulfate in antepartum eclampsia. Anatol J obstet Gynecol. 2010;1:1-4.

Chowdhury JR, Chowdhury S, Bhattacharya N, Biswas PK. Comparison of intramuscular magnesium sulfate with low dose intravenous magnesium sulfate regimen for treatment of eclampsia. J Obstet Gynaecol Research. 2009;35(1):119-25.

Bhattacharjee N, Saha SP, Ganguly RP, Patra KK, Dhali B, Das N, et al. A randomized comparative study between low-dose intravenous magnesium sulphate and standard intramuscular regimen for treatment of eclampsia. J Obstet Gynaecol. 2011;31(4):298-303.

Ekele BA, Muhammed D, Bello LN, Namadina IM. Magnesium sulfate therapy in eclampsia: the Sokoto (ultra-short) regimen. BMC Research Notes. 2009;2:1-6.

Begum MR, Begum A, Quadir E. Loading dose versus standard regime of magnesium sulfate in the management of eclampsia: A randomized trial. J Obstet Gynaecol. 2002;28(3):154-9.

Singh BM. Hypertensive disorders in pregnancy. In: Mishra R editor. Ian Donald’s Practical obstetric problems. 6th ed. New Delhi: BI Publications Pvt Ltd; 2007: 280-367.

Begum R, Begum A, Johanson R, Ali MN, Akhter S. A low dose (‘Dhaka’) magnesium sulphate regime for eclampsia Acta Obstet Gynecol Scand. 2001;80:998-1002.

Heman LM, Paul JQ, Linden VD. Does magnesium sulfate increase the incidence of postpartum hemorrhage? A systematic review. Open Journal of Obstetrics and Gynecology. 2011;1:168-73.

Das M, Chaudhuri PR, Mondal BC, Mitra S, Bandyopadhyay D, Pramanik S. Assessment of serum magnesium levels and its outcome in neonates of eclamptic mothers treated with low-dose magnesium sulfate regimen. Indian Journal of Pharmacology. 2015;47(5):502-8.