title: Magnesium sulphate therapy in eclampsia: the Sokoto (ultra short) regimen.
abstract: BACKGROUND
  Continuing the administration of magnesium sulphate for 24 hours after the last fit in patients with eclampsia is at best empirical. The challenge of such a regimen is enormous in low-resource countries. The objective of this study was to assess the effectiveness of an ultra-short regimen of magnesium sulphate in eclamptics.
  
  
  RESULTS
  This was a prospective, cohort study of eclamptic patients admitted between July 2007 and June 2008 that were given 4 grams magnesium sulphate intravenously and 10 grams intramuscularly (5 grams in each buttock) as the sole anticonvulsant agent. Main outcome measure was the absence of a repeat fit. Other aspects of eclampsia management were as in standard practice. One hundred and twenty one (121) patients were managed with this regimen. There were 29 ante partum, 76 intrapartum and 16 post partum cases of eclampsia. Most of the patients were primigravidae (100; 83%) with an average age of 18.7 years. There were nine cases (7.4%) of recurrent fits that occurred within four hours of the loading dose. One recurrent fit occurred in the ante partum group, seven in the intra partum and one in the post partum group. There were 12 maternal deaths giving a case fatality rate of 9.9%.
  
  
  CONCLUSIONS
  Limiting the dosage of magnesium sulphate to 14 grams loading dose (4 grams intravenous and 10 grams intramuscular) was effective in controlling fits in 92.6% of cases in the study group. A properly conducted, randomized controlled trial is needed to test our proposed regimen.
authors.affiliation: Department of Obstetrics and Gynecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. bissekele@yahoo.com
authors.forename: Bissallah A
authors.initials: BA
authors.lastname: Ekele
authors.forename: Danjuma
authors.initials: D
authors.lastname: Muhammed
authors.forename: Lawal N
authors.initials: LN
authors.lastname: Bello
authors.forename: Ibrahim M
authors.initials: IM
authors.lastname: Namadina
references.citation: BJOG. 2009 Jan;116(2):247-56
references.pmid: 19076957
references.citation: Int J Gynaecol Obstet. 2007 May;97(2):150-1
references.pmid: 17368649
references.citation: Afr J Med Med Sci. 2000 Sep-Dec;29(3-4):239-41
references.pmid: 11713998
references.citation: Am J Obstet Gynecol. 1978 Jul 15;131(6):591-7
references.pmid: 686045
references.citation: Am J Obstet Gynecol. 1984 Apr 1;148(7):951-63
references.pmid: 6711634
references.citation: Hypertens Pregnancy. 2003;22(3):257-65
references.pmid: 14572362
references.citation: Neurosci Lett. 1985 Jan 7;53(1):21-6
references.pmid: 2859558
references.citation: J Obstet Gynaecol Res. 2002 Jun;28(3):154-9
references.pmid: 12214831
references.citation: Afr J Reprod Health. 2001 Aug;5(2):30-5
references.pmid: 12471911
references.citation: West Afr J Med. 2002 Jan-Mar;21(1):74-6
references.pmid: 12081352
references.citation: Trop Doct. 2008 Jan;38(1):11-3
references.pmid: 18302851
references.citation: Ann Afr Med. 2007 Dec;6(4):164-7
references.pmid: 18354940
references.citation: Lancet. 1995 Jun 10;345(8963):1455-63
references.pmid: 7769899
references.citation: Int J Gynaecol Obstet. 2007 Jan;96(1):62-6
references.pmid: 17188273
references.citation: J Obstet Gynaecol. 2004 Feb;24(2):142-7
references.pmid: 14766449
references.citation: Lancet. 2008 Mar 1;371(9614):705-6
references.pmid: 18313488
references.citation: Neurology. 1987 Sep;37(9):1555-7
references.pmid: 3627458
references.citation: BMJ. 2005 Oct 1;331(7519):765-9
references.pmid: 16195297
references.citation: Int J Gynaecol Obstet. 2004 Nov;87(2):149-50
references.pmid: 15491562
references.citation: Lancet. 2006 Apr 1;367(9516):1066-1074
references.pmid: 16581405
references.citation: Acta Obstet Gynecol Scand. 2001 Nov;80(11):998-1002
references.pmid: 11703195