Published: 2019-08-26

Correlation of serum magnesium levels in eclampsia with pritchard and single dose magnesium sulphate regimen

Shreya M. S., Nayana D. H.


Background: Magnesium sulphate is anticonvulsant of choice for eclampsia. Single dose magnesium sulphate therapy was tried for the management of Eclampsia and Imminent Eclampsia considering the low body mass index of Indian population.

Methods: A prospective interventional study comprising of total 80 patients having either eclampsia or imminent eclampsia, to whom the Pritchard or a single dose MgSO4 was given alternatively in a tertiary hospital   from October 2014 to October 2017. Serum magnesium levels, maternal and perinatal outcome and recurrence of convulsions were evaluated using Student- t test and chi square test.

Results: Mean Serum Magnesium levels in eclampsia and imminent eclampsia group at 0 min, 30 min, 4 hours in Pritchard regimen were 1.96mg/dl, 5.85mg/dl, 4.68mg/dl while in single dose regimen it was 1.78mg/dl, 462mg/dl, 3.63mg/dl respectively. Those who received Pritchard regimen showed higher level of Serum magnesium levels at 30 minutes and 4 hours than those receiving single dose. By applying T-test it was found that there is a significant difference in serum magnesium levels range in both group but no statistical difference in the control of convulsions in both groups.

Conclusions: With increased and almost widespread use of magnesium sulfate in obstetrics there has been concerns regarding its safety. In the study, although P-values are not significant because of small sample size, there is considerable difference in serum magnesium levels 30 min and 4 hours, recurrence of convulsions and maternal morbidity between Pritchard regimen and single dose regimen. The goal which was achieved with Pritchard regimen previously, now can be achieved with single dose regimen in Indian women. Single dose magnesium sulphate is safe and effective in controlling convulsions with improved maternal and perinatal outcome.


Background: Magnesium sulphate is anticonvulsant of choice for eclampsia. Single dose magnesium sulphate therapy was tried for the management of Eclampsia and Imminent Eclampsia considering the low body mass index of Indian population. Methods: A prospect

Full Text:



Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):323-33.

Abalos E, Cuesta C, Carroli G, Qureshi Z, Widmer M, Vogel JP, et al. WHO multicountry survey on maternal and newborn health research network. preeclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization multicountry survey on maternal and newborn health. BJOG. 2014;121(1):14-24.

Dutta DC. Hypertensive disorders in pregnancy. In: Konar H, editor. DC Dutta's Text Book of Obstetrics. 8th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2015:268.

Duley L. The eclampsia trial collaborative group. which anticonvulsant for women with eclampsia?. evidence from the collaborative eclampsia trial. Lancet. 1995;345:1455-63.

Pritchard JA, Cunningham FG, Pritchard SA. The parkland memorial hospital protocol for treatment of eclampsia: evaluation of 245 cases. Am J Obstet Gynecol. 1984;148:951-63.

Duley L, Henderson- Smart D, Chou D: Magnesium sulphate versus phenytoin for eclampsia; Cohrane Database of Systemic Reviews. 2010;10:CD000128.

Begum R, Begum A, Johanson R, Ali MN, Akther S. A low dose (“Dhaka”) magnesium sulphate regime for eclampsia’. Acta Obstet Gynecol Scand. 2001; 80(11):998-1002.

Jana N, Dasgupta S, Das AK, Santra D, Samanta B. Experience of a low-dose magnesium sulfate regimen for the management of eclampsia over a decade. Int J Gynaecol Obstet. 2013;122:13-7.

Sardesai S, Maira S, Patil A. Low dose magnesium sulphate therapy for eclampsia and imminent Eclampsia - regimen tailored for Indian women. J Obstet Gynecol India. 2003;53:546-50.

Shilva, Saha SC, Kalra J, Prasad R. Safety and efficacy of low-dose MgSO4 in the treatment of eclampsia. Int J Gynaecol Obstet. 2007;97:150-1.

Bangal V, Kwatra A, Raghav S, Jadhav S. Low dose magnesium sulphate regime for Eclampsia. Pravara Med Rev 2009;4:13-5.

Mahajan NN, Thomas A, Soni RN, Gaikwad NL, Jain SM. 'Padhar regime' - a low-dose magnesium sulphate treatment for eclampsia. Gynecol Obstet Invest. 2009;67:20-4.

Sibai BM. Magnesium sulphate is the ideal anticonvulsant in preeclampsia- eclampsia. Am J Obstet Gynecol. 1990;162:1141-5.

Fernandez FJ, Kahn HL. Clinical method for atomic absorption spectroscopy. Clin Chem Newsl. 1971;3:24-8.

Suyajna DJ, Veerendra CM. Single dose MgSO4 regimen for eclampsia - A safe motherhood initiative. J Clin Diagn Res. 2013;7(5):868-72.

Dasgupta S, Sarkhel A, Jain A. Single loading dose of magnesium sulphate in severe preeclampsia and eclampsia-is it effective? A randomized prospective study. Obstet Gynecol Int J. 2015;2(6):59.

Shohaib T, Khan S, Javed I, Bhutta S. Loading dose of magnesium sulfate versus standard regime for prophylaxis of pre-eclampsia. J Coll Physicians Surg Pak. 2009;19(1):30-3.

Barbieri RL, Repke JT. Maternal disorders during pregnancy. In :Fauci AS, Braunwald E, Kesper DL et al, editors. Harrison’s Principles of Internal Medicine, 17th Ed. New York: Mc Graw Hill; 2008:44-49.

Tudela CM, McIntire DD, Alexander JM. Effect of maternal body mass index on serum magnesium levels given for seizure prophylaxis. Obstet Gynecol. 2013;121(2 Pt 1):314-20.

Biswas A, Modak R, Aksi S, Biswas S. Epidemiological study of eclampsia in a referral teaching hospital. 2005;103(6):323-4.

Ekele BA, Muhammed D, Bello LN, Namadina IM. Magnesium sulfate therapy in eclampsia: the Sokoto (ultra short) regimen. BMC Res Notes. 2009;2:165.

Hill S, Yang A, Bero L. Priority medicines for maternal and child health: a global survey of national essential medicines lists. PloS One. 2012;7(5):e38055.

Suchitra R, Vinuthna NK, Devi S, Bai SK, Begum S. Comparison of low dose, single loading dose and standard Pritchard regimen of magnesium sulphate in antepartum eclampsia. Int J Current Res. 2015;7(9):20204-07.

Regmi MC, Aggrawal A, Pradhan T, Rijal P, Subedi A, Uprety D. Loading dose versus standard regimen of magnesium sulphate in eclampsia – a randomized trial. Nepal Med Coll J. 2010;12:244‑7.

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