English

Abstract

BACKGROUND: Eclampsia is a life threatening condition and it varies from countries to countries .The incidence in our country varies from 5-10%. The first and foremost thing in management of eclampsia is control of convulsions. Magnesium sulphate has established itself as the drug of choice for the anticonvulsant management of eclampsia but the question as to what constitutes the Minimum effective dose remains unanswered which is evident from the different regimens used in clinical practice. Its narrow therapeutic range mandates that it only be used in the minimum doses which gives efficient control of convulsions and helps in improving maternal and fetal outcome. Aims: To study the efficacy and safety of single loading dose of magnesium sulphate in controlling and prevention of recurrence of convulsion in eclampsia, to reduce the adverse affects of magnesium sulphate and improve the maternal and fetal outcome with single loading dose. Methods: Prospective study of 100 cases with clinical diagnosis of eclampsia were given single loading dose of magnesium sulphate [4 g of 20% IV and 10 g of 50 % IM], there was no maintenance dose. The effect of singe loading dose of magnesium sulphate in controlling convulsions, the recurrence rates, toxicity and the maternal and fetal outcome was studied. Results: The results showed a favorable outcome with the reduction of the dose and duration of magnesium sulphate therapy. The primary outcomes were comparable with all other regimens in use. With recurrence rate of 9% its efficacy was comparable with the other regimens in use. The cases that were on single dose regimen had a significantly lower incidence of cesarean section with up to 74% of the patients having vaginal deliveries. The maternal mortality was 3% and perinatal mortality was 29%. Conclusions: Single loading dose of magnesium sulphate is effective in controlling and prevention of recurrence of convulsions in eclampsia. The single most advantage of this regimen was the complete absence of any incidence of magnesium sulphate toxicity and it is easy to administer in any place. Painful injections and monitoring of magnesium sulphate toxicity seen in maintenance dose can be avoided with this regimen.