Loading dose of magnesium sulphate versus standard regime for prophylaxis of pre-eclampsia.
OBJECTIVE
To determine the efficacy of single dose of magnesium sulphate versus the standard Pritchard regime in the management of pre-eclampsia.


METHODS
Quasi-experimental study.


METHODS
Jinnah Postgraduate Medical Centre, Karachi, from January 2004 to January 2006.


METHODS
All women with severe pre-eclampsia and impending eclampsia were included in the study. Patients with pregnancy induced hypertension and mild to moderate pre-eclampsia were excluded. From the 100 women included in the study, after matching for age, parity and gestational age, 50 were given only bolus dose of magnesium sulphate and 50 were given the standard regime. They were observed for one week for the number of convulsions. Fisher's exact test and Chi-square test were used to analyze results.


RESULTS
There was no significant difference in the two groups in term of occurrence of seizures, one patient developed fit with Pritchard regimen. The rate of caesarean section was lower in group A, 12% versus 30% in group B (p=0.05). There was no significant difference in perinatal outcome in either group (82% live births in group A versus 72% amongst group B (p=0.2). Few side effects like vomiting, dizziness and irritation at the site of injection were observed when standard treatment was used. Single dose treatment was also found to be cost-effective costing Pak Rs. 45 (US $ 0.56) as compared to Pak Rs. 195 (US $ 2.4) in control group. No maternal death was observed in either group.


CONCLUSIONS
Having the equal effectiveness, ease of monitoring and cost-effectiveness, single loading dose of magnesium sulphate is preferable over the standard regime in the management of pre-eclampsia as a prophylactic measure for prevention of seizure.
Shoaib
Tabassum
T
Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi. tabassu@yahoo.com
Khan
Saba
S
Javed
Iffat
I
Bhutta
Shereen Z
SZ
D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D005260:Female; D005865:Gestational Age; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D010298:Parity; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012640:Seizures / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult
D000927:Anticonvulsants; D008278:Magnesium Sulfate