A randomised comparative study between low-dose intravenous magnesium sulphate and standard intramuscular regimen for treatment of eclampsia

Abstract

In a randomised control study, we evaluated the efficacy of intravenous low-dose magnesium sulphate for the management of eclampsia. A total of 144 women with eclampsia were divided into a study group and a control group of 72 women each. The study group received 0.75 g/h of magnesium sulphate intravenously after a loading intravenous dose of 4 g and the control group was given the standard intramuscular regimen as advocated by Pritchard. The primary outcome measure was recurrence rate of the seizures. The secondary outcome measures were development of magnesium toxicity if any, and maternal and perinatal outcomes. The difference in the incidence of fit recurrence was statistically insignificant when both groups were compared (7.46% vs 8.57%, p = 0.939). The total dose of magnesium sulphate was significantly lower in the intravenous group (p < 0.0001), in which no patient developed magnesium toxicity. Low-dose intravenous magnesium sulphate was found to be as effective as the standard intramuscular regimen, while maintaining a high safety margin.

Comparison of low dose Dhaka regimen of magnesium sulphate with standard pritchard regimen in eclampsia

“…Atonic PPH was significantly more with Pritchard regimen as compared to Dhaka regime in the present study Due to its induction of vasodilation and effects on the blood like red cell deformity, platelet activity inhibition and a prolonged bleeding time, there is a correlation between magnesium sulphate therapy and PPH is suspected. 10 Similar results were obtained in the study conducted by Seth S et al and Bhattacharjee N. 3,5 In the present study, recurrence of fits was significantly less with Pritchard regimen (6.7%) as compared to Dhaka regimen (21.4%). However, in none of the cases recurrence of fits observed for more than once.…”

“…Early neonatal death and perinatal mortality was higher with Pritchard regimen however, difference was not significant. The results are in collaboration with study conducted by Seth S et al, Chaudhary JR et al and Bhattacharjee N. [3][4][5] Apgar was significantly less at 1 and 5 minutes with Prichard regimen as compared to those who were given Dhaka regimen. Similar results were observed in the study conducted by Seth S et al, 88.9% of those on standard regimen and 53.3% of those on low dose regimen had Apgar less than 5 in 1 minute.…”

“…[3][4][5] However, In our study, there was no mortality among those cases that were treated with either of the regimen.…”

“…Magnesium sulphate toxicity is extremely rare with correct preparation of the infused magnesium solution and diligent clinical monitoring. Study conducted by various authors (Seth S et al 3 , Chaudhary JR et al 4 and Bhattacharya N et al 5 ) had shown prolonged labour, increased caesarean rate and increased postpartum hemorrhage.…”

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

“…PPH was seen in both group and was not statistically significant but in some studies as that of Bhattacharya N et al it was statically significant. 13 The maternal mortality rate in our study was found to be 8 (7%) in low dose regimen and 11 (9.6%) in standard regimen group. Study by Jana N et al, had reported maternal mortality rate of 3.3% whereas another study had shown the MMR 32% in collaboration eclampsia rate.…”