‘Single Dose MgSo4 Regimen’ for Eclampsia - A Safe Motherhood Initiative

D, Joshi Suyajna; Cm, Veerendrakumar

doi:10.7860/jcdr/2013/5398.2961

Cited by 8 publications

(9 citation statements)

References 11 publications

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“…Recurrent convulsion rate while using a low maintenance dose regime in the present study was 9.6%. Which was comparable to other studies like Joshi's VIMS regime (9.16%) 14 and Suman Sardesai's low dose magnesium sulfate regime 11 (7.8%). 15 Recurrent convulsions after therapy (if at all occurred) could be controlled immediately by giving 2 g (20% solution) IV as a loading dose followed by 1 g/hour IV maintenance dose without any serious consequences.…”

Section: Discussionsupporting

confidence: 90%

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Making Magnesium Sulfate Therapy Safer in Eclampsia: A Comparative Study of Zuspan Regime vs Low-dose Intravenous MgSO4 Regime

Vaishnav¹,

Raithatha²,

Kathawadia³

et al. 2019

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objective: Magnesium sulfate is a universally accepted drug for the control of convulsions in eclampsia. Regimes available have been well tried in western countries where the weight of women is much higher than Indian women. In the present study, we tried to compare the doses used in zuspan regime (used previously in our hospital) with the regime where we reduced the maintenance dose to half for average weight women of the rural area (≤50 kg). Design: A PRE-POST comparative study of 2 regimes of magnesium sulfate therapy in cases of eclampsia. Setting: Tertiary care center in the low-resource rural area of central Gujarat. Population: Group I: All patients of eclampsia, March 2007 to April 2012. Group II: All patients with eclampsia who were weighing ≤50 kg (BMI ≤25) May 2012-Oct 2013. Materials and methods: Group I: Zuspan regime: Loading dose 4 g intravenously 20% over 20 minutes and maintenance dose 1 g/hour intravenously. Group II: Low maintenance dose regime: Loading dose: 4 g intravenously 20% over 20 minutes and maintenance dose: 0.5 g/hour. Main outcome measures: Rates of recurrence of convulsions, magnesium sulfate toxicity, and maternal mortality. Results: Recurrent convulsion rate was 5% in group I and 9.6% in group II. Toxicity was seen in 15.3% of cases in group I while it was not seen in group II. Maternal mortality in group I was 1.5% and no mortality in group II. Conclusion: A low maintenance dose of magnesium sulfate is safe and effective for controlling convulsions in patients with eclampsia weighing ≤50 kg.

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Section: Discussionsupporting

confidence: 90%

“…Injection of calcium gluconate 10%, 10 mL was given in a case of detection of magnesium sulfate toxicity. 14 Antihypertensives (like labetalol, nifedipine or nitroglycerine drip) were used to control severe hypertension and were administered to keep diastolic blood pressure at around 90 mm Hg.…”

Section: Toxicitymentioning

confidence: 99%

Making Magnesium Sulfate Therapy Safer in Eclampsia: A Comparative Study of Zuspan Regime vs Low-dose Intravenous MgSO4 Regime

Vaishnav¹,

Raithatha²,

Kathawadia³

et al. 2019

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…Postpartum eclampsia accounted for 10.3% of the cases. 15 Antenatal eclampsia (76.78 %); post-partum convulsions (13.72%) are also significant. 5 428 cases (82.1%) of eclampsia was ante-partum/ intrapartum and 93 cases (17.9%) were postpartum.…”

Section: Discussionmentioning

confidence: 98%

Burden of eclampsia: a persisting problem in the developing countries

Babbar¹,

Armo²,

Murthy³

2015

Int J Reprod Contracept Obstet Gynecol

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Background: Hypertensive disorders of pregnancy constitute one of the major threats to maternal health. Eclampsia is still a leading cause of maternal morbidity and mortality in developing countries. This study was carried out to determine the incidence of eclampsia, demographic profile of patients, obstetric outcome, fetal outcome, maternal morbidity and mortality. Methods: A 5 year retrospective observational study included 521 patients who presented in emergency with eclampsia and admitted between April 2010 and March 2015, in the department of Obstetrics and gynecology, government medical college (Chhattisgarh institute of medical sciences) and tertiary care hospital Bilaspur, Chhattisgarh. Results: Based on 14,876 pregnancies in the 5 year period in our referral hospital, we estimated an incidence of 3.5%.70.8% were primigravida and 86.4% of patients had no regular antenatal care. Majority of the cases (82.1%) presented as antepartum/intrapartum eclampsia in the age group 20-24 years (65.4%).The patients usually presented at term(62.4%) with 69.7% having vaginal delivery as compared to 30.3% undergoing LSCS. The fetal outcome showed 56.2% live-births, 25.5% had early neonatal death and 13.3% stillborn. The complications most commonly observed were puerperal sepsis (11 %),oliguria(8.1%), pulmonary edema(5.9%) and maternal mortality as 8.4 %. Conclusions: Most of the life-threatening eclampsia cases can be prevented by simple awareness and motivation towards antenatal care. In Chhattisgarh state where majority of rural population are tribal, illiterate, living in difficult to reach areas, delay in referral, due to unavailability of clinicians or medical officers in peripheral areas for antenatal examination.The best way to reduce the burden is by creating an awareness, proper antenatal care, timely referral and thus prevent the occurrence of eclampsia.

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“…Hence in India, standard Pritchard's regimen has been subjected to various modifications like Dhaka regimen, VIMS regimen, Suman and Sardesi regimen etc due to concerns over cost of treatme safety and limited patient to doctor ratio requiring regular and frequent monitoring of the patients who receive MgSO4. 8,[15][16][17] But the main question was what should be the ideal dose. Therefore in present study serum magnesium levels of eclamptic pregnant women receiving Pritchard regimen was compared with those treated with low dose regimen.…”

Section: Discussionmentioning

confidence: 99%

“…Antepartum eclampsia is commonest as shown by many studies which is comparable with the study which was seen in 70%. 8,[15][16][17] The normal serum magnesium levels vary from 1.6 to 2.1mEq/l. An IV dose of 4g Magnesium sulphate causes an immediate elevation of Magnesium level from normal to 7 to 9 mEq/L, subsequently due to intracellular transfer and renal elimination the concentration drops to 4 to 5 mEq/L by one hour.…”

Section: Discussionmentioning

confidence: 99%

Correlation of serum magnesium levels in eclampsia with pritchard and single dose magnesium sulphate regimen

Shreya

Nayana

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Magnesium sulphate is anticonvulsant of choice for eclampsia. Single dose magnesium sulphate therapy was tried for the management of Eclampsia and Imminent Eclampsia considering the low body mass index of Indian population.Methods: A prospective interventional study comprising of total 80 patients having either eclampsia or imminent eclampsia, to whom the Pritchard or a single dose MgSO4 was given alternatively in a tertiary hospital from October 2014 to October 2017. Serum magnesium levels, maternal and perinatal outcome and recurrence of convulsions were evaluated using Student- t test and chi square test.Results: Mean Serum Magnesium levels in eclampsia and imminent eclampsia group at 0 min, 30 min, 4 hours in Pritchard regimen were 1.96mg/dl, 5.85mg/dl, 4.68mg/dl while in single dose regimen it was 1.78mg/dl, 462mg/dl, 3.63mg/dl respectively. Those who received Pritchard regimen showed higher level of Serum magnesium levels at 30 minutes and 4 hours than those receiving single dose. By applying T-test it was found that there is a significant difference in serum magnesium levels range in both group but no statistical difference in the control of convulsions in both groups.Conclusions: With increased and almost widespread use of magnesium sulfate in obstetrics there has been concerns regarding its safety. In the study, although P-values are not significant because of small sample size, there is considerable difference in serum magnesium levels 30 min and 4 hours, recurrence of convulsions and maternal morbidity between Pritchard regimen and single dose regimen. The goal which was achieved with Pritchard regimen previously, now can be achieved with single dose regimen in Indian women. Single dose magnesium sulphate is safe and effective in controlling convulsions with improved maternal and perinatal outcome.

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‘Single Dose MgSo4 Regimen’ for Eclampsia - A Safe Motherhood Initiative

Cited by 8 publications

References 11 publications

Making Magnesium Sulfate Therapy Safer in Eclampsia: A Comparative Study of Zuspan Regime vs Low-dose Intravenous MgSO4 Regime

Making Magnesium Sulfate Therapy Safer in Eclampsia: A Comparative Study of Zuspan Regime vs Low-dose Intravenous MgSO4 Regime

Burden of eclampsia: a persisting problem in the developing countries

Correlation of serum magnesium levels in eclampsia with pritchard and single dose magnesium sulphate regimen

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