Making Magnesium Sulfate Therapy Safer in Eclampsia: A Comparative Study of Zuspan Regime vs Low-dose Intravenous MgSO4 Regime

JOURNAL TITLE: Journal of South Asian Federation of Obstetrics and Gynaecology

Author
1. Nitin Raithatha
2. Smruti B Vaishnav
3. Ajay Phatak
4. Krina Kathawadia
5. Rakhee Patel
6. Nipa Modi
ISSN
0974-8938
DOI
10.5005/jp-journals-10006-1675
Volume
11
Issue
2
Publishing Year
2019
Pages
5
Author Affiliations
    1. Department of Obstetrics and Gynecology, Pramukhswami Medical College, Karamsad, Gujarat, India
    1. Department of Obstetrics and Gynecology, Pramukhswami Medical College, Karamsad, Gujarat, India
    1. Department of Obstetrics and Gynecology, Surat Municipal Medical College, Surat, Gujarat, India
    1. Department of Obstetrics and Gynecology, Pramukhswami Medical College, Karamsad, Gujarat, India
    1. Department of Obstetrics and Gynecology, Pramukhswami Medical College, Karamsad, Gujarat, India
    1. Department of Obstetrics and Gynecology, Pramukhswami Medical College, Karamsad, Gujarat, India
  • Article keywords
    Eclampsia, Low maintenance dose regime, Magnesium sulfate, Maternal mortality, Zuspan regime

    Abstract

    Objective: Magnesium sulfate is a universally accepted drug for the control of convulsions in eclampsia. Regimes available have been well tried in western countries where the weight of women is much higher than Indian women. In the present study, we tried to compare the doses used in zuspan regime (used previously in our hospital) with the regime where we reduced the maintenance dose to half for average weight women of the rural area (≤50 kg). Design: A PRE-POST comparative study of 2 regimes of magnesium sulfate therapy in cases of eclampsia. Setting: Tertiary care center in the low-resource rural area of central Gujarat. Population: Group I: All patients of eclampsia, March 2007 to April 2012. Group II: All patients with eclampsia who were weighing ≤50 kg (BMI ≤25) May 2012–Oct 2013. Materials and methods: Group I: Zuspan regime: Loading dose 4 g intravenously 20% over 20 minutes and maintenance dose 1 g/hour intravenously. Group II: Low maintenance dose regime: Loading dose: 4 g intravenously 20% over 20 minutes and maintenance dose: 0.5 g/hour. Main outcome measures: Rates of recurrence of convulsions, magnesium sulfate toxicity, and maternal mortality. Results: Recurrent convulsion rate was 5% in group I and 9.6% in group II. Toxicity was seen in 15.3% of cases in group I while it was not seen in group II. Maternal mortality in group I was 1.5% and no mortality in group II. Conclusion: A low maintenance dose of magnesium sulfate is safe and effective for controlling convulsions in patients with eclampsia weighing ≤50 kg.

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