Halve-dose Magnesium Sulphate Regimen Compared to the Pritchard Regimen in the Management of Pre-eclampsia and Eclampsia: A Prospective Single Blind Randomized Study in a Private Hospital

Authors

  • Olusanya Abiodun Department of obstetrics and gynaecology, Sacred Heart Hospital, Abeokuta, post code 110001, Nigeria
  • Oluwadara Ola Department of Family Medicine, Sacred Heart Hospital, Abeokuta, post code 110001, Nigeria
  • Omobolaji Oguntoyinbo Department of obstetrics and gynaecology, Sacred Heart Hospital, Abeokuta, post code 110001, Nigeria

Keywords:

half-dose regimen, Pritchard regimen, eclampsia, pre-eclampsia, magnesium sulphate.

Abstract

Hypertensive diseases in pregnancy constitute a major concern and it is a major cause of maternal and perinatal morbidity and mortality worldwide and especially in the resource-challenged countries. Regimens for administration of magnesium sulphate have evolved over the years with different regimens being advocated.   Objective: to compare the effectiveness of halve-dose regimen of magnesium sulphate therapy with standard Pritchard regimen in the management of patients with either pre-eclampsia or eclampsia. Result: out of 1,699 deliveries recorded during the period of study 74 patients that met the inclusion criteria were recruited for this study 75.7% presented primarily with pre-eclampsia while 24.3% presented with eclampsia primarily. Booked patients were 52.7% while 47.3% were unbooked. There were two arms of this study; the standard Pritchard and the half-dose regimen arms. The standard Pritchard regimen arm had 36 subjects while the half-dose regimen had 38 subjects respectively. The same number of subjects in the two arms progressed from pre-eclampsia to eclampsia. There were more patients with recurrent convulsion in the standard Pritchard regimen arm compared to the half-dose regimen though this was not statistically significant.

Case fatality was 1.35% and it was due to HELLP syndrome. Neonatal admission and mortality were not significantly different between the two arms of the study. Patients’ satisfaction was generally more in the half-dose regimen arm. Conclusion: from this study it is shown that giving half the dose of the standard Pritchard regimen is as effective as the standard Pritchard regimen itself. The import of this is that the risk of complications arising from magnesium sulphate is reduced, cost of treatment is also less, and overall general patient satisfaction is encouraging.

References

. S Dasgupta, A Sarkel, A Jain. “Single Loading Dose of magnesium Sulphate in Severe Pre-eclampsia and Eclampsia – Is it Effective? A prospective Study”. Obstet Gynecol Int. J. 2(6):00659,2015

. L Duley, DJ Henderson-Smart, G.J.A Walker. “Interventions for preventing pre-eclampsia and its consequences: generic protocol (Protocol).” The Cochrane Library. 2:1-14.2009

. GJ Hofmeyr, L Duley, A Atallah. “Dietary calcium supplementation for prevention of pre-eclampsia and related problems: a systemic review and commentary.” Br. J. Obstet Gynaecol 114:933-943,2007

. FG Cunningham, KJ Leveno, S.L Bloom, J.C Hauth, D.J Rouse, C.Y Spong (Eds). “Pregnancy Hypertension”, in Williams Obstetrics 23rd Edition, McGraw-Hills companies 2010; pp. 706-756.

. DI Miller. “Hypertension in pregnancy”, in: Current Diagnosis and Treatment Obstetrics and Gynaecology, 10th edition, AH Decherney, L Nathan, TM Goodwin and N Laufer (Eds), McGraw-Hill Medical Publishing Division 2007; pp 321- 327.

. K Sukonpan, V Phupong. “Serum calcium and serum magnesium in normal and pre-eclamptic pregnancy.” Arch Gynaecol Obstet 2005; 273:12-16.

. Engender Health. “BALANCING THE SCALES”. Expanding treatment for pregnant women with life-threatening hypertensive conditions in developing countries. A report on Barriers and solutions to Treat Pre-eclampsia and Eclampsia. New York: Engender Health; 2007

. MB Sibai, MA Villar, E Bray. “Magnesium supplementation during pregnancy: a double-blind study.” Br. J. Obstet Gynaecol. 1988; 950:120-5.

. BM Sibai. “Diagnosis, Prevention, and Management of Eclampsia,” Obstet Gynecol 2005; 105:402-10

. KO Osungbade, OK Ige. “Public Health Perspectives of Pre-eclampsia in Developing Countries: Implication for Health system strengthening.” Journal of Pregnancy [Review]. 2011; 2011:1-6

. Population Council Nigeria. “Administering Magnesium Sulphate to Treat severe Pre-eclampsia and Eclampsia,” 2009.Available at http://.popcouncil.org/script/tellafriend.asp.

. FE Olopade, TO Lawoyin. “Maternal Mortality in a Nigerian Hospital.” Afr J Biomed Research, 2008;11(3):276-273

. A Omole-Ohonsi, AO Ashimi. “Pre-eclampsia: a study of risk factors.” Nigerian Medical Practitioner 2008; 53(6):99-102

. A Gaym, P Barley, L Pearson, K Admasu, Y Gebrehiwot. “Disease burden due to Pre-eclampsia/eclampsia and Ethiopian health system’s response.” Int J Gynecol Obstet; 2011;115:112-116

. JATurner. “Diagnosis and management of pre-eclampsia: an update.” Int J Women’s Health, 2010;2:327-337

. L Duley. “The global impact of Pre-eclampsia and Eclampsia.” Semin Perinatol, 2009;33:130-137

. ET Agida, BI Adeka, KA Jibril. “Pregnancy outcome in Eclamptics at the University of Abuja Teaching Hospital, Gwagwalada, Abuja: A 3year review.” Nigerian J of Clinical Practice 2010;13(4):394-398

. L Duley, HE Matar, MQ Almerie, D.R Hall. “Alternative Magnesium Sulphate regimens for women with pre-eclampsia and eclampsia (Review).” © 2010(8) The Cochrane Collaboration

. AE Bisallah, M Danjuma, NB Lawal, MN Ibrahim. “Magnesium therapy in eclampsia: Sokoto (Ultra short) regimen.” BMC Research Notes 2009,2;165 doi:10.1186/1756 – 0500-2-165

. N Jana, S Dasgupta, AK Das, D Santra, B Samanta. “Experience of a low-dose magnesium sulfate regimen for the management of eclampsia over a decade.” Int.J Gynecol Obstet (2013), http://dx.doi.org/10.1016/j.ijgo.2013.01.029

. MA Belfort, KJ Moise. “Effect of Magnesium sulphate on maternal brain blood flow in Pre-eclampsia: a randomized, placebo controlled study.” Am J Obstet Gynecol 1992;167;661-6

. O Abiodun, OA Oguntayo, AI Sambo. “Serum levels of calcium and magnesium in pre-eclamptic-eclamptic patients in a tertiary institution.” It. J. Gynaecol. Obstet. 2015, 27: 101-110 N.3 DOI: 10.14660/2385-0868-23

. O Olusanya, EE Okpere, M Ezimokhai. “The importance of socioeconomic class in voluntary fertility in a developing country.” W Afr J Med 1985;4:205-12

. Center for Health Service Development. “The Short Assessment of Patient Satisfaction (SAPS).” University of Wollongong pp1-2

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Published

2019-03-15

How to Cite

Abiodun, O., Ola, O., & Oguntoyinbo, O. (2019). Halve-dose Magnesium Sulphate Regimen Compared to the Pritchard Regimen in the Management of Pre-eclampsia and Eclampsia: A Prospective Single Blind Randomized Study in a Private Hospital. International Journal of Sciences: Basic and Applied Research (IJSBAR), 44(2), 125–134. Retrieved from https://www.gssrr.org/index.php/JournalOfBasicAndApplied/article/view/9690

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