Studies on Low Dose Magnesium Sulfate in Eclampsia in a Tertiary Care Hospital

Eclampsia is a major obstetric problem that can cause significant morbidity and even death in both the mother and the child. The Pritchard regimen is a well-known anticonvulsant strategy that has shown to be effective in the treatment of eclampsia. A low-dose MgSO4 regimen is being tested to decrease MgSO4 toxicity in low-weight Indian women. The low dose protocol consists of a loading dose of 4 gm MgSO4 slow IV, followed by a maintenance dose of 2 gms MgSO4 slow IV every three hours; continued for 24 hours after delivery or 24 hours after the last convulsion, whichever is later; If a convulsion occurs during treatment, an additional dose of 2 gms of MgSO4 is given slow IV in addition to the regular dose.

In the years 2017 and 2018, 123 women were diagnosed with eclampsia. 69 women were hospitalised for eclampsia, 15 of whom developed eclampsia after admission, and 39 women were referred for management from other hospitals. Antenatal or antepartum eclampsia affected 60% of the women. One-third of the women experienced postpartum eclampsia, with the rest suffering from intrapartum eclampsia. 40% of women had a blood pressure of less than 160/110 mm Hg, while 60% had a blood pressure of more than 160/110 mm Hg. Two-thirds of the 81 direct admissions experienced eclampsia at or after 37 weeks; 60% had unassisted vaginal delivery; 1/6 had instrumental vaginal delivery; and 1/4th of the women were terminated by LSCS. Thirteen of the 81 women were admitted with absent FH; five experienced intrapartum foetal death; 90 percent of the 63 live deliveries had a fair Apgar score; 10% had a poor Apgar score at 5 minutes of delivery; and three babies died prematurely. One woman had eclampsia with 10 fits, went into coma and died. Others are on their way to being discharged. The low-dose MgSO4 regimen is just as effective as Pritchard's. When compared to the Pritchard regimen, maternal and foetal morbidity and death were essentially same in the low dosage regimen.