A comparative study of maternal outcome between low dose and standard dose magnesium sulphate as regimen for the treatment of eclampsia in a tertiary centre (original) (raw)
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Efficacy of Magnesium Sulphate on Maternal Morbidity and Mortality in Eclampsia
Pakistan Armed Forces Medical Journal
Objective: To study efficacy of Magnesium Sulphate in reducing maternal morbidity and mortality in patients presenting with eclampsia. Study Design: Prospective observational study. Place and Duration of Study: Gynae/Obs Department, Combined Military Hospital Bannu, from Jan 2018 Sep 2019. Methodology: A total of 134 patients fulfilling inclusion criteria were included in the study. Patient management was multidisciplinary. Convulsions were controlled by 4gram magnesium sulphate intravenously over 20 minutes as a loading dose, followed by 1gram per hour of maintenance infusion. Blood pressure was controlled with injection Labetalol 10 milligram followed by injection Hydralazine repeated after every 20 minutes till the blood pressure was controlled. Results: A total of 134 patients had eclampsia constituting 6.8% of obstetric admissions. Case fatality was 14 (10.4%) while 120 (89.55%) of the cases responded well to treatment and survived the event. Mean age of patients was 22 years. ...
Biomedical & Pharmacology Journal, 2013
Eclampsia is a leading cause of maternal and perinatal morbidity and mortality in developing countries. MgSO 4 in the Pritchard regime is associated with more toxicity. This study was conducted in 50 eclamptic patients in Teerthanker Mahaveer Medical College Hospital & Research Centre, Moradabad, U.P. to find out the efficacy of Low Dose Magnesium sulphate regime for the control of convulsions. Low dose MgSO 4 regime was found to be safe and effective in eclampsia along with bringing down the total cost of therapy.
Background: Eclampsia is a hypertensive disorder related to pregnancy, in which there is occurrence of one or more generalized convulsions and or coma, in the absence of other neurologic conditions. It is a common obstetric emergency. Eclampsia is associated with elevated maternal and fetal morbidity and mortality. Objectives: To compare the efficacy of low dose magnesium sulphate (Dhaka) regime with Pritchard regime in Eclampsia. Material and Methods: A prospective randomized study of fifty eclampsia cases, treated with magnesium sulphate (25 each from low dose magnesium sulphate (Dhaka) regime and Pritchard regime) was carried out for one year i.e. January 2010 to December 2010 at Pravara Rural Hospital, Loni. Results were analysed using Statistical Package of Social Sciences (SPSS) 13.0. Results: In the present study, convulsions were controlled in 88% of eclampsia cases with low dose magnesium sulphate (Dhaka) regime. Two cases i.e. 8% had single episode of recurrence of convulsion, which was controlled by giving additional 2 grams of 20% magnesium sulphate intravenous single dose. Perinatal mortality in low dose magnesium sulphate (Dhaka) regime was lesser (24%) than Pritchard regime (32%). Conclusion: Low dose magnesium sulphate (Dhaka) regime was equally effective as Pritchard regime in control of eclamptic convulsions. There was no magnesium related toxicity with low dose magnesium sulphate (Dhaka) regime. Maternal and perinatal outcome was better in low dose magnesium sulphate (Dhaka) regime as compared to Pritchard regime.
Magnesium sulphate in the prophylaxis and treatment of eclampsia
Journal of Ayub Medical College, Abbottabad : JAMC
Magnesium Sulphate is considered to be the agent of choice for the control of eclamptic seizures in pregnant women. Our objectives were to determine frequency of eclampsia and pre-eclampsia in our unit and to determine the effect of initial loading dose of magnesium sulphate on maternal and fetal outcome. This study was carried out in Department of Gynaecology at Lady Reading Hospital, Peshawar. In the year 2000 only 133 patients received magnesium sulphate out of 228 cases of eclampsia and pre eclampsia due to the problems with the continuous supply of the drug. This included 53 cases of eclampsia and 80 cases of pre-eclampsia. Information regarding the dosage of magnesium sulphate labor out come, maternal and fetal outcome, side effects and complications of therapy were evaluated from hospital case records. The magnesium sulphate regimen consisted of 4 gm loading dose as 20% solution intravenously over 10-15 minutes followed immediately by 5 gm into each buttock. Dose of 5 gm intr...
Maternal and fetal outcome in eclamptic convulsion with Magnesium sulphate therapy
IP Innovative Publication Pvt. Ltd., 2017
Eclampsia accounts for 50,000 maternal deaths a year worldwide. The maternal case fatality rate is 1.8% and 35% of eclamptics will have one major complication. Objective: objective of study was to improve maternal and fetal outcome with single dose of magnesium sulphate therapy. Results: 100 cases of eclampsia admitted to Karnataka Institute of Health Sciences, Hubli were belong to lower socio economic status, majority of them were Hindus and illiterates. 82% had vaginal delivery and 15% had LSCS for fetal indication. In 52 cases, induction was done. LSCS was done in 11 cases in induction group, 8 cases were for fetal distress and 3 were for failed induction. Maternal mortality in our study was 1% and the cause was acute pulmonary edema. Commonest complication encountered in our study was the renal failure. In our study 70 of the them were live born out of which 49 were pre term and 21 were term. 71% of the them had birth weight of more than 1.5Kg. Among this 46 perinatal deaths, 30 were still born and 16 were neonatal death, thus giving the perinatal mortality of 46%. Conclusion: It was concluded that Magnesium sulphate is safe and effective in controlling convulsions with improved maternal and perinatal outcome.
Low Dose Magnesium Sulphate Regime for Eclampsia and Imminent Eclampsia
International Journal of Current Research and Review, 2020
Introduction: In India especially in rural areas, the majority of eclampsia cases report to hospital in an emergency. They are unregistered with inadequate antenatal care and travel a long distance before reaching the hospital as the rural health centres are not sufficiently equipped to manage this condition. Aim: To determine the efficacy of low dose magnesium sulphate in eclampsia and imminent eclampsia. To measure serum levels of magnesium with this regime. To correlate serum magnesium levels and efficacy. To identify complications of magnesium sulphate therapy in the mother and the baby. Methods: 120 cases of preeclampsia and eclampsia were allotted by simple random sampling technique to two groups i.e. low dose regime group and Pritchard regime group. It was observed that the majority of the cases were unbooked (90%) and were in the age group of 21-25 years (76.6%). Results: Study observed that eclampsia was primarily a disease of primigravida (61%). Most women in the study group had a bodyweight of fewer than 50 kgs (74%). The average total dose of magnesium sulphate required was 20 grams i.e. 54.5% less than that required in standard Pritchard regime. Majority of the cases (90%) responded to the low dose regime with the recurrence rate being (10%) as compared to Pritchard regime group being (91.6%) and recurrence being 8.33%. The success rate for seizure prophylaxis in imminent eclampsia being 100% in both the groups. The average serum magnesium levels low dose regime in sample 1 was 3.36±0.76 and 3.30±0.69 for sample 2. The therapeutic serum magnesium levels for the present low dose regime being 2.61 to 4.05 mg/dl. The cost of therapy while doing so was reduced to less than half with low dose regime than that of Pritchard regime. The perinatal mortality was 30% with low dose regime. Conclusion: Low dose magnesium sulphate regime was effective in seizure prophylaxis in imminent eclampsia patients and as effective as Pritchard regime in eclampsia patients. The dose required for control of convulsions was less than half used in Pritchard regime and even cost of therapy was half than Pritchard regime..
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Eclampsia is derived from the Greek word meaning flash of lightening, to shine forth. It is defined as the occurrence of generalized tonic-clonic convulsion in women with pre-eclampsia not caused by any other neurological or medical disorders. It is one of the most common obstetrical emergencies in developing countries causing significant maternal and perinatal morbidity and mortality. Incidence of eclampsia is 1 in 2000 deliveries in developed countries and 1 in 50 to 500 deliveries in developing countries. 1 In India, the incidence of eclampsia ranges from 6 to100 per 10,000 live births. 2 It accounts to 12% of maternal deaths worldwide as compared to 8% in India. 3 The worldwide estimated eclampsia deaths per year is 50,000. 4 The principle management for eclampsia is control of convulsions along with supportive life measures and termination of pregnancy. Magnesium sulphate (MgSO4)
Role of low dose Magnesium sulphate in eclampsia
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
Background: Eclampsia is one of the challenging medical complications seen during pregnancy. With the use of magnesium sulphate for control of convulsion in eclampsia, it can be managed effectively.Methods: This is a prospective study done in a tertiary care hospital. Considering low body mass index of patients of developing area, authors had used low dose regime of magnesium sulphate. 100 patients had been enrolled for low dose magnesium sulphate regime after categorizing patients as per inclusion and exclusion criteria. The primary outcome to be measured was recurrence of fits in any patients who received low dose magnesium sulphate. The secondary outcome measured were development of any toxicity, level of serum magnesium level, maternal and perinatal outcome.Results: It was observed that 93% of the patients responded to low dose regime. 7% developed recurrence of fits for that additional dose of 2 gram of 20% magnesium sulphate was given to the patients. Not even a single patien...
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Eclampsia contributes to maternal mortality in developing, underdeveloped world. Various drugs have been tried to treat eclampsia. Magnesium sulphate has become the drug of choice due to various advantages and is associated with adverse outcome for both mother and fetus if not used correctly. This study was undertaken to know safety, efficacy of reduced doses of Magnesium sulphate as compared to standard dose. Materials and Method: After obtaining institution ethical clearance and written informed consent this study was conducted on 60 subjects for 2 years. Patients diagnosed as eclampsia and presenting with generalized tonic clonic seizure during antenatal, intrapartum, postnatal were included. Group A received single loading dose of magnesium sulphate (4gm (20%) I V over 3-5 min followed by 10gm (50%) deep i.m. (5gm in each buttock)). Group B patients received low dose magnesium sulphate (4gm (20%) i.v. over 3-5 min followed by 6gm (50%) deep i.m. (3 gm in each buttock) and maintenance dose of 3 gm i.m., every 4 hourly in alternate buttock) which was continued 24 hours after last convulsion or delivery whichever is later. Mode of delivery, recurrence of convulsion, maternal and fetal morbidity and mortality were studied. Results: Maternal and foetal outcome was comparable in both the groups. There was no significant difference with regards to recurrence of convulsions. There was no statistically significant increase in incidence of caesarian section in group B compared to group A (p>0.05). Conclusion: Single dose regime controls the eclamptic convulsions with good maternal and neonatal outcome.
Magnesium Sulphate Therapy in Eclampsia: A 5 Years Experience at a Teaching Hospital
Journal of Postgraduate Medical Institute, 2011
Objective : To describe the presentation of eclampsia, its management and associated outcomes using Methodology: This descriptive study was conducted at Obstetrics and Gynecology unit, Hayatabad Medical Complex, Peshawar from January 2004 to December 2008. Data was collected from all patients presenting with eclampsia. Results : A total of 146 patients had eclampsia. Unbooked were 124 (84.93%). Mean age 23 years ± 5.3 years (range 18-38 years), primigravida were 69.17 %(101 cases). Antepartum fits in 72.6 % (106 cases), intrapartum 14 (9.58%) and 27(18.49%) postpartum. MgSO4 was used in all except 4 with oliguria, they were given diazepam. Recurrent fit occurred in only 20(13.69%). MgSO4 toxicity occurred as respiratory depression in 9 cases., depressed tendon reflexes in 10 and decreased urine output in 13 cases Total deliveries were 23021, prevalence of eclampsia was 0.63% .Mode of delivery was Vaginal in 97 (66.43%), instrumental in 29 (19.98%) and cesarean section in 20 (13.69%)...