Comparative study of low dose magnesium sulphate regime with Pritchard regime in eclampsia

Abstract

Introduction: Eclampsia is still a leading cause of maternal mortality and morbidity. Magnesium sulphate despite being an anticonvulsant of choice remains underutilized due to fear of toxicity. Average weight of Indian women is less than the western women due to which lower dose of magnesium sulphate can be used in treatment of eclampsia. The aim of the study was to compare the efficacy of low dose magnesium sulphate regimen with Pritchard regimen, in the control of convulsion in eclampsia. We also compared neonatal and maternal outcome in these two group.

Methodology: This randomized control study was carried out at Emergency Labour room, Government Medical College, Nagpur. 160 patients of eclampsia were divided randomly into study group (n=80) receiving low dose MgSO4 and control group (n=80) receiving Pritchard regimen. The recurrence of convulsion, toxicity profile and maternal and fetal outcome was studied.

Results: Majority of patients 73.75% were primigravida and 77.5% unbooked cases. 91.5% had antepartum/intrapartum eclampsia. 6 (7.5%) patients in study group had recurrence of convulsion as compared to 11 (13.75%) in Pritchard regimen group (p =0.31). Toxicity of MgSO4 in the form of lost tendon reflexes and respiratory depression was significantly less in those receiving Low dose of MgSO4 (p<0.001). Respiratory depression developed in one patient in control group and none in study group. Maternal mortality was 2.5% in both the groups. Perinatal mortality was 28.75% in the study group and 33.73% in control group.

Conclusions: Low dose Magnesium sulphate regimen was equally effective in the control of convulsions in eclampsia and can be safely used in Indian women.