Tabassum Shoaib, Iffat Jawed, Shereen Bhutta.
Magnesium sulphate prophylaxis in pre-eclampsia.
J Surg Pak Jan ;12(4):161-5.

Objective: To determine the efficacy of magnesium sulphate in the management of preeclampsia. Study Design: Quasi-experimental. Place & Duration of study: Ward 8, Department of Obstetrics & Gynaecology, Jinnah Post Graduate Medical Center (JPMC) Karachi, from January 2004 to December 2004. Patients & Methods: A study was done using non random purposive sampling. Study population consisted of 100 pre-eclamptic women. All women with severe pre-eclampsia and impending eclampsia were recruited in the study with blood pressure more than140/100 mm Hg, proteinuria ++ on dipstick or signs and symptoms of impending eclampsia like epigastric pain, nausea, vomiting, headache associated with sever hypertension. Fifty patients had magnesium sulpahte prophylaxis and 50 (control group) without any anticonvulsant. Before giving magnesium sulphate, the clinician checked that knee and other tendon reflexes were present, respiratory rate was normal(more than 16 breaths per minute) and urine output more than100 ml in last four hours or greater than 25 ml in last four hours. Results: The average age of patients with magnesium sulphate prophylaxis was 28.06±5.5 years and for controls, it was 27.88±5.46 years. A significant reduction in the rate of eclampsia in women assigned to magnesium sulphate 2% versus 12% (p<0.05,OR 0.15) was noted. However there was no significant reduction in the rate of abruptio placentae in either group, 6% versus 8% (p>0.5). The rate of caesarean section was lower in women given magnesium prophylaxis 6% versus 17% (p=0.01). There was no significant difference in perinatal outcome in either group, 41% live births in study versus 38% amongst controls (p=0.91). No maternal death was observed in either group. Conclusions: Magnesium sulphate minimizes the risk of eclampsia and decreases the morbidity and mortality related to eclampsia but at the same time it does not prevent the progression of pre-eclampsia and therefore maternal and fetal surveillance should be continued irrespective of magnesium sulphate prophylaxis.

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