Comparison of 12 hours versus 24 hours I/V Administration of MgSO4 in the Management of Eclampsia
Sadia Khan, Pareesae Humayun, Shabnam Naseer Awan, Sadiqa Batool Naqvi, Rabia Mohsin, Zobia Jawad
Aim: To determine the maternal outcomes in patients receiving 12-hour versus 24-hour maintenance dose of MgSO4 for the management of eclampsia.
Methods: The randomized clinical study containing 100 patients who developed eclampsia after childbirth was conducted in the department of obstetrics and gynecology, CMH Multan, the study duration was June-2019 to April-2020. In all patients immediately after birth, 4 gram loading dose of MgSO4 was given in 10 minutes. In group A; maintenance dose of MgSO4 1 Gram/hour infusion was given for 12 hours. In group B; maintenance dose of MgSO4 1 Gram/hour infusion was given for 24 hours. Maternal outcomes were primary study endpoints.
Results: Majority of patients were having age >30 years (27 (54%) in 12-hour group versus 28 (56%) in 24-hour group). There was no single incidence of seizures in any of the groups. However, patients in 24-hour group required extended hours of monitoring with mean duration of 31.7±4.6 hours and in 12-hour group monitoring was done only for 19.4±4.8 hours (p <0.0001). Mean time of insertion of Foley catheter was also prolonged in 24-hour group, 32.1±3.9 hours versus 19.6±2.8 hours in 12-hour group (p <0.0001)..
Conclusion: 12-hour MgSO4 regimen is effective in reducing the risk of recurrent seizures in eclampsia patients. 12-hour MgSO4 administration requires shorter duration of monitoring and allows early patient mobility. Moreover, it leads to early discharge of patient from the hospital.
Keywords: Eclampsia, Magnesium sulphate, seizures.