Efficacy of Loading Dose of Magnesium Sulphate versus Standard Pritchard Regimen for Controlling of Fits in Eclampsia

Abstract

Objective: To determine the efficacy of loading dose of magnesium sulphate verses standard Pritchard regime for controlling of fits in eclampsia.

Study Design: Randomized controlled trial study

Place and Duration of Study: This study was conducted at the department of Obstetrics and Gynaecology Unit II Civil Hospital Karachi from July 2016 to December 2016 for a period of six months.

Materials and Methods: There were 132 women with antepartum, intrapartum and postpartum eclampsia irrespective of age, parity and gestational age were included in the study. Women with known case of epilepsy, space occupying lesion, magnesium sulphate sensitivity, renal failure, history of administration of magnesium sulphate prior to admission and those with contraindication of magnesium sulphate like myasthenia gravis were excluded. Women who fulfilled the inclusion and exclusion criteria were randomly allocated into two groups. Group A comprise of 66 women who received Standard Pritchard regimen (loading dose and maintenance dose). Group B also comprise 66 women who received only loading dose. The efficacy of drug i.e. occurrence of convulsion after completion of therapy was observed.

Results: The mean age of the participants in group A was 29+5.2 years and 27+3.6 years in group B. The average BMI in group A and group B was 28.51+1.6 kg/m² and 28.40+1.5 kg/m² respectively. Majority of the participants in group A were nulliparous 22(33.33%) and multiparous 28(42.42%) in group B. Postpartum eclampsia was observed in 49(37.1%), followed by antepartum 44(33%) and intrapartum 39(29.5%). Women who were treated with standard Pritchard regimen, fits was controlled in 62(93.94%) only 4(6.06%) had recurrence of convulsions while in loading dose group 8(12.12%) had recurrence of convulsions and 58(87.87%) women remained fits free. Single loading dose is equally effective as standard Pritchard regimen.

Conclusion: Magnesium sulphate is the most preferable drug for prevention and treatment of eclamptic patients. The single loading dose of magnesium sulphate is equally effective as standard Pritchard regimen in prevention of convulsions with the added advantage of reduced toxicity, fewer side effects and ease of monitoring.