DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20211490

Effective role of the ‘loading’ dose of magnesium sulfate in the treatment of eclampsia

Halima Khatun, M. Saiful Islam, Tarikul Islam

Abstract


Background: Eclampsia is defined as the occurrence of one or more convulsions in association with the syndrome of preeclampsia. In Bangladesh, eclampsia is the 3rd major cause of maternal death. Magnesium sulfate is now the drug of choice for women with eclampsia for controlling convulsion with strong evidence that it is better than diazepam, phenytoin or lytic cocktail. Aim of the study was to find out the effective role of loading dose of magnesium sulfate in the treatment of the convulsion in eclampsia.

Methods: Prospective comparative study. In the Department of Obstetrics and Gynaecology, Rajshahi Medical College Hospital (RMCH)" from January 2008 to December 2008. A total of 100 eclamptic patients who are eligible for magnesium sulfate therapy were purposively assigned to receive either only loading "dose or traditional dose for control of convulsion. Data was organized and the results were presented in tables, figures, diagram etc. by using SPSS-10 and MS-Excel 2016.

Results: The mean (±SD) convulsion (fit) and delivery interval was 7.95±1.33. Regained consciousness was predominant 28(56.0%) patients after initiation of treatment. Maternal death was found 1 (2.00%). The cause of maternal mortality was due to renal failure. The mean (±SD) respiratory rate was 20.2±4.19min. Normal urine was found 43(86.0%). Normal knee jerks were found 45 (90.0%). No toxicity developed in any group assessed by the parameters like respiratory rate, urine volume and knee jerks.

Conclusions: For the above reasons eclampsia can be treated effectively by only loading dose of Mgs04 in primary as well as tertiary level hospital which will significantly reduce the maternal morbidity and mortality.


Keywords


Convulsion, Eclampsia, Magnesium sulfate (MgS04), Preeclampsia

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References


Robson SC. Hypertension and rena. disease in pregnancy. In: Endmonds OK, editor, Dewhurst's text book of Obstetrics and Gynaecology for postgraduates 6th ed. London: Black well Scientific publications, Black well Scientific Publication. 2000; 166-85.

The Eclampsia Trial Collaborative Group, which anticonvulsant for women with eclampsia? Evidence from the collaborative Eclampsia Trial, Lancet. 1995;345(8963):1455-63.

Reynoids C, Mabie we, Sibai BM. Hypertensive state pregnancy. In: De cheronsy AH, Nathare I, editors. Current obstetric and gynecologic diagnosis and treatment 10th ed. New York: Lange Medical Book, Me Graw-H ill Med Publish Div. 2007:318-27.

Mattar F, Shibai 8M, Eclampsia. Risk factors for maternal morbidity. Am J Obstet Gynaec, 2000;182(2):307-12.

Alam S, Shamsuddin L, Charabarty GK, Begum M, Islam S. Intravenous Magnesium sulphate in the management of Eclampsia. Bangladesh J. Obstet Gyneco, 2002;17(2):56-9.

Begum MR, Begum A, Quadir E. Loading' dose versus standard regime of magnesium sulfate in the management of eclamsia: A randomized trial. Obstet Gyneeco. 2002;28(3):154-9.

Hospital Statistics, Rajshahi Medical College Hospital. Rajshahi, Bangladesh.

Begum R, Begum A, Johanson R, Ali MN, Akhter S. A low dose ('Dhaka') magnesium sulfate regime for eclampsia. Acta Obstet Gynecol Scand. 2001;80(11):998-1002.

Rouf S, Shamsudin L, Khan JH. Magnesium sulfate versus diazepam in the management of eclampsia. Bangladesh J Obstet Gyneco. 1996;11:1-14.

Chien PF, Khan KS, Arnott N. Magnesium sulfate in the treatment of eclampsia and pre eclampsia: an overview of the evidence from randomized trials. Br J Obstet Gynaeco. 1996;103(11):108-91.

Eclampsia Working Group, Eclampsia in Bangladesh. A review & guideline. Bangla J obstet and Gynaec. 1997;12:1-27.

Phuapradit W, Saropala N, Haruvasin S, Thuvasethakul P. Serum level of magnesium attained in magnesium sulfate therapy for severe preeclampsia. Asia‐Oceania J Obstet and Gynaec. 1993;19(4):387-90.

Chesely LC. Parentral magnesium and the distribution, plasma levels and excretion of magnesium. Am J Obstet & Gynaec. 1979;133(1):1-7.

Begum R, Bhuiya AB, Tahera S. Incidence of low birth weight baby in Dhaka Medical College and Hospital. Bangla an Obstet Gynaeco. 1995;10(1):26-37.

Khan JH. MgS04 vs diazepam in the management of eclampsia (Dissertation) Dhaka. Bangladesh College of Physi and Surg.

Sibai BM. Magnesium sulfate prophylaxis in preeclampsia; Lessons learned from recent trials. Am J Obstet and Gynaec. 2004;190(6):1520-6.