Premium
Experience of a low‐dose magnesium sulfate regimen for the management of eclampsia over a decade
Author(s) -
Jarayan,
Dasgupta Subhendu,
Das Anindya Kumar,
Santra Debjyoti,
Samanta Balaram
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.01.029
Subject(s) - regimen , medicine , eclampsia , magnesium , case fatality rate , anesthesia , loading dose , obstetrics , pregnancy , surgery , materials science , metallurgy , genetics , epidemiology , biology
Objective To assess the safety and efficacy of a low‐dose magnesium sulfate regimen for the management of eclampsia in Indian women. Methods A loading dose consisting of 3 g of magnesium sulfate intravenously plus 5 g intramuscularly (2.5 g in each buttock) was followed by 2.5 g intramuscularly every 4 hours, for 24 hours beyond the last seizure. In a first phase, which spanned 2001 and 2002, the regimen was evaluated prospectively with 554 women with eclampsia, and the results were compared with results from the Collaborative Eclampsia Trial. Regarding the second phase, which spanned the 9 following years, mortality was analyzed retrospectively for 2929 women treated by the same regimen at the same hospital. Results The mean ± SD maternal weight and height were 41.7 ± 5.3 kg and 151 ± 7 cm, respectively. The low‐dose regimen was associated with a lower seizure recurrence (6.1% vs 9.7%; P = 0.02) and a slightly lower maternal mortality (2.7% vs 3.2%; P = 0.6) compared with the Collaborative Eclampsia Trial. The overall case fatality rate for the second phase was 3.3%. Conclusion The low‐dose regimen was safe and effective for the management of eclampsia in a region where most women are of light weight.