A Lower Dose of Mgso4 for Control of Convulsions in Bangladeshi Eclamptic Women

Abstract

Introduction: Eclampsia is the third major cause of maternal death in Bangladesh contributing to 16 percent of total maternal mortality rate (MMR)¹. Standard practice in eclampsia is urgent control of convulsions and prevention of its recurrence with the help of a suitable anticonvulsant, prompt initiation of general and obstetric care and control of hypertension if needed. Methodology: This prospective cross-sectional analytic study was conducted in Dhaka Medical College Hospital (DMCH) eclampsia unit during August 2004 to January 2005 in order to determine whether 8 g of magnesium sulphate heptahydrate is sufficient in controlling convulsion and preventing recurrences in lighter Bangladeshi women instead of 10 g of magnesium sulphate (MgSO4) as loading dose that is now being used. One hundred consecutive eclamptic patients who were eligible for magnesium sulphate therapy were assigned by lottery to receive either 8 g of magnesium sulphate heptahydrate (MgSO4. 7H₂O) (group A) or 10 g of magnesium sulphate (group B). The two groups were well-balanced and comparable on important characteristics. Result: The results show that there was no significant difference between the two groups with respect to recurrent convulsion, time needed to regain consciousness and maternal and perinatal morbidities and mortalities. Conclusion: The results reveal that 8 g magnesium sulphate heptahydrate is as effective as 10 g MgSO4 (as loading dose) in management of eclamptic convulsion of Bangladeshi women. If 8 g of magnesium sulphate heptahydrate can be used, it will be more economic, painful intramuscular injections will be avoided and the risk of toxicity will be reduced