Magnesium sulphate therapy in eclampsia and pre-eclampsia

Authors

  • Smriti Sagar Department of Obstetrics and Gynecology, Sri Aurobindo Medical College, Indore, Madhya Pradesh, India
  • Neeta Natu Department of Obstetrics and Gynecology, Sri Aurobindo Medical College, Indore, Madhya Pradesh, India
  • Nootan Chandwaskar Department of Obstetrics and Gynecology, Sri Aurobindo Medical College, Indore, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20183315

Keywords:

Convulsions during pregnancy, Eclampsia, Hypertension, Imminent eclampsia, Magnesium sulphate regimen

Abstract

Background: Maternal and perinatal mortality and morbidity remains high during pregnancy in the presence of eclampsia, it can have severe adverse effects on mother and the fetus. So, its management should be a top priority. The objective of the present research was to study the effect of magnesium sulphate in control of imminent eclampsia and eclampsia.

Methods: 19 cases of eclampsia and 185 cases of imminent eclampsia were treated with standardized magnesium sulphate. The outcome measures in terms of recurrence of convulsions, maternal and neonatal outcome, etc. were seen.

Results: Most common age group in both the groups were 21-30 years (i.e. 78.9% with eclampsia and 75.7% with imminent eclampsia). In both the groups, majority of the women were primigravidae. In eclampsia group, 9 (47.4%) women had 1 episode of convulsion, 8 (42.1%) women had two episodes of convulsions, 1 (5.3%) women each had 3 and 4 episodes of convulsions, while there were no convulsions in imminent eclampsia women (‘t’ value = 28.558, df=202, p=0.000). Vomiting and headache (94.7%) were the most common premonitory symptoms in eclampsia group, followed by edema in 68.4% women, while in imminent eclampsia 64.9% women had headache, 57.8% women had edema and 43.2% had vomiting. Recurrence of convulsions were seen in 4 (21.1%) women of the eclampsia group even after giving maintenance dose and additional dose of magnesium sulphate. 1 (5.3%) death was seen in eclampsia group and none in the imminent eclampsia group. Neonatal mortality in eclampsia group (47.4%) was higher than imminent eclampsia group (11.7%), which was statistically significant (Z value = 3.05, p=0.002).

Conclusions: Magnesium sulphate regimen was effective in control of convulsions in eclampsia and as prophylaxis in imminent eclampsia.

References

Lambert G, Brichant JF, Hartstein G, Bonhomme V, Dewandre PY. Preeclampsia: an update. Acta Anaesthesiol Belg. 2014;65(4):137-49.

American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-31.

Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):1-7.

Arulkumaran N, Lightstone L. Severe pre-eclampsia and hypertensive crises. Best Pract Res Clin Obstet Gynaecol. 2013;27(6):877-84.

WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia: Implications and Actions. Available at: http://apps.who.int/iris/bitstream/handle/10665/119627/WHO_RHR_14.17_eng.pdf?sequence=1. Accessed on 13.08.2017.

Henderson JT, Whitlock EP, O'Connor E, Senger CA, Thompson JH, Rowland MG. Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;160(10):695-703.

Smith JM, Lowe RF, Fullerton J, Currie SM, Harris L, Felker-Kantor E. An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management. BMC Pregnancy Childbirth. 2013;13:34.

McDonald SD, Lutsiv O, Dzaja N, Duley L. A systematic review of maternal and infant outcomes following magnesium sulfate for pre-eclampsia/eclampsia in real-world use. Int J Gynaecol Obstet. 2012;118(2):90-6.

Sardesai S, Maira S, Patil A, Patil U. Low dose magnesium sulphate therapy for eclampsia and imminent eclampsia: regime tailored for Indian women. J Obstet Gynaecol Ind. 2003;53(6):546-50.

Nath J, Sharma R, Mahajan SS. A study on low dose magnesium sulphate regime for eclampsia in a tertiary care teaching hospital in North India. Biomed Pharmacol J. 2013;6(1):29-32.

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(11):998-1002.

Downloads

Published

2018-07-26

Issue

Section

Original Research Articles