Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Idowu A, Adekanle DA, Loto OM, Ajenifuja KO, Badejoko OO, Tijani Am and Mustapha AO
Background: Eclampsia is a major cause of maternal and perinatal morbidity and mortality. Magnesium sulphate is currently the gold standard in the management of eclamptic fit. As a result of its toxicity, current efforts are being geared towards discovering a lower dosage without compromising its efficacy.
Objective: To compare the effectiveness of low-dose magnesium sulphate and standard Pritchard regimen in controlling eclamptic fit and preventing adverse maternal and neonatal outcomes in eclamptic patients
Methodology: This study was a randomized clinical trial comparing low-dose with standard Pritchard regimen. Twenty eight patients (the cases) randomized into low-dose regimen group received 4g loading dose, I.V. 4 g and a maintenance dose of 0.6 g/hr through intravenous infusion for a period of 24 hours post-delivery or after the last fit. The control arm of the study were twenty eight patients in the Pritchard regimen group and received loading dose of 14 g followed by maintenance dose of 5 g 4 hourly for a period of 24 hours post-delivery or after the last fit. In both study groups, additional 2 g of I.V. magnesium sulphate was given for recurrent convulsions.
Results: The mean age of the 56 patients was 25.5 ± 5.7 years. 33 (58.9% were nullipara), 54 (96.4%) were unbooked, 33 (58.9%) had antepartum eclampsia, 17 (30.4%) had preterm delivery, 2 (3.6%) had primary postpartum haemorrhage which was the commonest complication. Recurrent rate of convulsion ranges between 3.6% to 7.1% and it’s not different among the study groups. There were no differences in neonatal outcomes in both groups.
Conclusion: From this study, low-dose magnesium sulphate appears to be as effective as the standard Pritchard regimen in controlling eclamptic fit. The additional benefit of the intravenous low-dose magnesium sulphate is: it cost less and chances of toxicity are reduced.