title: Loading dose versus standard regime of magnesium sulfate in the management of eclampsia: a randomized trial.
abstract: OBJECTIVE
  To determine whether only loading dose of magnesium sulfate is effective in controlling convulsion in eclampsia.
  
  
  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 (MgSO4) therapy were randomly assigned by lottery to receive either only loading dose (n = 202) or standard regime (n = 199) of MgSO4. 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 chi2 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 +/- 4.29h), fit and delivery interval (11.35 +/- 10.22 vs 11 +/- 6.69h) and return of consciousness (10.94 +/- 8.29 vs 11.24 +/- 8.37h). 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).
  
  
  CONCLUSIONS
  Only loading dose of MgSO4 can control convulsion in eclampsia and it is as effective as standard regime.
authors.affiliation: Department of Obstetrics and Gynecology, Dhaka Medical College and Hospital, Bangladesh. ehsann@bttb.net.bd
authors.forename: Mosammat Rashida
authors.initials: MR
authors.lastname: Begum
authors.forename: Anowara
authors.initials: A
authors.lastname: Begum
authors.forename: Ehsan
authors.initials: E
authors.lastname: Quadir
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage*; D004461:Eclampsia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012008:Recurrence; D012640:Seizures / Q000517:prevention & control
chemical_list: D000927:Anticonvulsants; D008278:Magnesium Sulfate