Shortened versus standard post-partum maintenance therapy of magnesium sulphate in severe pre-eclampsia: a randomised control trial
Keywords:Preeclampsia, maternal/perinatal morbidity and mortality, Pritchard regimen, MgSO4
Background: Pre-eclampsia is a pregnancy-associated multi-organ disorder caused by altered trophoblastic invasion and endothelial cell dysfunction. It is associated with significant maternal and perinatal morbidity and mortality, especially in developing countries. Magnesium sulphate (MgSO4) is effective in the management of severe pre-eclampsia/eclampsia. Objective of this study was to compare the effectiveness of a shortened course of MgSO4 to the Pritchard regimen in patients with severe pre-eclampsia
Methods: This study was carried out at the obstetrics and gynecology department of the Obafemi Awolowo University Teaching Hospital, Ile-Ife. It was a randomised control study of 116 patients, 58 in each group. Group A received the standard Pritchard regimen: a loading dose of MgSO4 4g slow IV bolus plus 10 g IM (5 g in each buttock), followed by maintenance dose of 5g MgSO4 IM 4-hourly into alternate buttocks until 24 hours after delivery. Group B received same loading dose, but the maintenance dose was limited to three doses of 5g MgSO4 IM four hours apart after delivery. In both regimens, 2g MgSO4 was given IV for breakthrough fit. Data were analyzed using SPSS version 20.
Results: This study revealed that twelve-hour postpartum MgSO4 was as effective as the Pritchard regime with no statistically difference in occurrence of seizures (X2 = 0.341, df = 1, p = 0.514). The average total dose of magnesium sulphate used was lower in the study Group B.
Conclusions: Twelve-hour postpartum MgSO4 is as effective as the standard 24-hour Pritchard regime.
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