Feasibility of low dose magnesium sulphate for eclampsia-a randomized study

Eclampsia is a preventable malady, yet remains a leading cause of maternal mortality and morbidity worldwide. Magnesium sulphate despite being the anticonvulsant of choice largely remains underutilized in low resource settings due to various constraints. Tailoring the dose as per local needs has given the scope to adopt a lower dose in these countries. We aimed to compare the efficacy of low dose regimen of magnesium sulphate (MgSO4) with Pritchard's regimen in patients of eclampsia.

A prospective cross sectional study was carried out in the department of Obstetrics and Gynecology at Himalayan Institute of Medical Sciences, Dehradun, India over a period of one year which included a total of 60 patients of eclampsia divided into two groups by randomization. Group A received low dose magnesium sulphate (Dhaka regimen) and Group B patients were managed with Pritchard's regimen of MgSO4. The recurrence of fits, toxicity profile and feto-maternal outcome was studied. Data generated was analyzed using SPSS version 20.

Majority of the patients were primigravida (66.67%) and unbooked (73%). Low dose regimen was equally effective in controlling the seizures and only two patients (6.6%) had recurrent seizures (p=1.00). Incidence of loss of deep tendon reflex was 10% with low dose Mgso4 and 13.3% with standard dose (p=0.69). Mean values of serum magnesium in both the groups was comparable. There was one maternal death in our study.

With an efficacy comparable to Pritchard's regimen in controlling eclampsia, low dose Mgso4 is a viable alternative especially at primary and secondary health care levels.