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Loading dose versus standard regime of magnesium sulfate in the management of eclampsia: A randomized trial
Author(s) -
Begum Mosammat Rashida,
Begum Anowara,
Quadir Ehsan
Publication year - 2002
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1046/j.1341-8076.2002.00029.x
Subject(s) - medicine , eclampsia , blood pressure , anesthesia , convulsion , magnesium , proteinuria , randomization , glasgow coma scale , gestational age , hypermagnesemia , randomized controlled trial , pregnancy , epilepsy , hypomagnesemia , genetics , materials science , psychiatry , metallurgy , biology , kidney
Objective: To determine whether only loading dose of magnesium sulfate is effective in controlling convulsion in eclampsia. Study methods: This prospective study was conducted in Dhaka Medical College and Hospital, Bangladesh between July and November 1999. Eclamptic patients who were eligible for magnesium sulfate (MgSO 4 ) therapy were randomly assigned by lottery to receive either only loading dose ( n = 202) or standard regime ( n = 199) of MgSO 4 . Besides the anticonvulsant, patients of both the groups were managed by same protocol for eclampsia management prepared by Eclampsia Working Group, Bangladesh. Efficacy of both the regimes was assessed by measuring the rate of recurrent convulsion. Results were expressed as mean ± SD and a proportion. Statistical analysis was done using unpaired t ‐test, Z ‐test and χ 2 test as appropriate. A P ‐value of <0.05 was considered significant. Results: At the time of randomization there were no significant differences between the two groups in terms of age (22.40 ± 4.21 vs 22.49 ± 4.67 years), parity (72.77% vs 70.35% primi), type of eclampsia (84.65% vs 85.42% antepartum eclampsia), number of convulsions (5.30 ± 3.26 vs 5.48 ± 3.32 times), gestational age (35.65 ± 3.37 vs 35.13 ± 3.26 weeks), systolic blood pressure (153.19 ± 20.19 vs 154.17 ± 22.32 mmHg), diastolic blood pressure (106.23 ± 13.84 vs 105.60 ± 12.88 mmHg), proteinuria (70.80% vs 72.36% had > + proteinuria) and Glasgow Coma Scale (GCS) (73.26% vs 75.88% >8) for the loading and standard regime groups. There were also no differences between the two groups in mean fit and treatment interval (6.88 ± 5.26 vs 7.12 ± 4.29 h), fit and delivery interval (11.35 ± 10.22 vs 11 ± 6.69 h) and return of consciousness (10.94 ± 8.29 vs 11.24 ± 8.37 h). The recurrent convulsion rate was almost the same in both the groups (3.96% in loading vs 3.51% in standard regime, P > 0.05). Case fatality rate was 4.45% and 5.02% in loading and standard regime groups, respectively ( P > 0.05). Conclusion: Only loading dose of MgSO 4 can control convulsion in eclampsia and it is as effective as standard regime.