Comparison of Intramuscular Magnesium Sulphate with Low Dose Intravenous Regimen in the Management of Eclampsia in Low Resource Setting: A Randomised Study
- *Corresponding Author:
- Adekanle DA
Department of obstetrics and gynaecology
College of Health Sciences, Ladoke Akintola University of Technology
P.M.B. 4400, Osogbo, Osun State, Nigeria
Received date: June 19, 2014; Accepted date: September 17, 2014; Published date: September 22, 2014
Citation: Idowu A, Adekanle DA, Loto OM, Ajenifuja KO, Badejoko OO, et al. (2014) Comparison of Intramuscular Magnesium Sulphate with Low Dose Intravenous Regimen in the Management of Eclampsia in Low Resource Setting: A Randomised Study. Gynecol Obstet (Sunnyvale) 4:249. doi: 10.4172/2161-0932.1000249
Copyright: © 2014 Idowu A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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.