Magnesium Sulphate in Eclampsia and Pre-Eclampsia - A Case Series Of 103 Patients Treated with Single Loading Dose of MgSO4 (14 Grams) At Holy Family Hospital, Rawalpindi
Objective: To determine the efficacy of single loading dose (14 grams) of magnesium sulphate (MgSO4) as an anti-convulsant in the management of eclampsia and severe pre-eclampsia.
Methods: A prospective study was conducted at Obs/Gynae Department, Holy Family Hospital, Rawalpindi over a period of three years. The patients who needed MgSO4 due to eclampsia or severe pre-eclampsia were included in the study. The patients were given 14 grams MgSO4 (4 grams I/V bolus diluted in 20 ml N/S + 5 grams I/M on each buttock) as the sole anticonvulsant agent. Other aspects of the management were as in the standard practice. The main outcome measure was the occurrence of seizure within 24 hours after Mgso4 therapy. All observations were recorded on a specially designed proforma.
Results: Total patients recruited were 103, including 61 eclamptics and 42 pre-eclamptics. Mean age was 27 years. In 42 (40.8%), fits occurred antenatal, 5 (4.8%) intrapartum and 14 (13.5%) postpartum. Seizures occurred in 6 (5.8%) patients within 24 hours after the loading dose of MgSO4; 5 (8.1%) among eclamptics and 1 (2.3%) among pre-eclamptics. The vaginal delivery rate was 64% and the LSCS rate was 35.9%. There were 38 (36.8%) perinatal deaths and one maternal expiry (0.97%).
Conclusions: The single loading dose of MgSO4 can be used with good seizure control and less chances of toxicity and hence a good option in low-resource countries to decrease the maternal mortality rate.
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