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Ab s t r Ac t 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.

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