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Feb 10, 2005Keywords:
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Eclampsia: A Randomized Double Blind Trial of Magnesium Sulphate and Diazepam in Lagos, Nigeria
Abstract
Objective: This randomnized study is to compare the efficacy of magnesium sulphate with that of diazepam in preventing seizures in hypertensive women during labour.
Methods: Eclamptic patients were randomly assigned to receive either magnesium sulphate or diazepam. The magnesium sulphate regimen used was as described by Zuspan. The diazepam regimen was a loading dose of 10mg intravenously over two minutes and repeated when convulsions recurred.
Primary measure of outcome: Recurrence of convulsions and maternal death.
Results: The use of magnesium sulphate was found to be significantly associated with less serious morbidity in terms of recurrence of convulsions (P = 0.0047), respiratory, and renal complications (P = 0.004) and improvement in level of unconsciousness (P = 0.0024) in comparison to diazepam use. Eight maternal deaths occurred, seven (87.5%) in unbooked/ predelivery patients. More vaginal delivery and less operative delivery were recorded in the magnesium group as compared to the diazepam group (P = 0.039). Low Apgar scores < 7 at 1min were twice as common in the diazepam group as compared to the magnesium sulphate group (P = 0.04). There were four early neonatal deaths in the diazepam group and none in the magnesium sulphate group.
Conclusion: This study has produced support for the touted advantages of magnesium sulphate over diazepam for the mother and the infant in the treatment of eclampsia.
Key Words: Eclampsia, Recurrent Convulsions, Magnesium sulphate,Diazepam
[Trop J Obstet Gynaecol, 2004; 21:143-147]
