Safety and efficacy of Bolus administration of magnesium sulphate for preeclampsia
AbstractContext: Magnesium sulphate is currently the drug of choice in the prevention and treatment of eclampsia. On-going research is addressing its administration in terms of dosage, duration and safety.
Objective: We evaluated a modified method of magnesium sulphate administration with respect to safety, efficacy and maternofetal outcome.
Design, Setting And Subjects: This was a prospective cohort study conducted at the UBTH, Benin City with patients managed for severe preeclampsia between June and December, 2011. The Zuspan regimen was compared with a modified intravenous regimen in which magnesium maintenance therapy was given as 1g hourly bolus injection administered over 10 minutes. Both methods were evaluated for safety, efficacy and materno-fetal outcome.
Result: The mean age, parity, gestational age and body mass index were 28.09±5.5 years, 2.72±1.98, 36.67±3.54 weeks and 26.51±5.60 respectively. Both methods achieved therapeutic levels, but blood pressure control was better in the continuous group than the bolus group (27% vs 100%, P=0.000). Birth asphyxia occurred in 14.8% of the babies and was 3 times more in the continuous group (22% vs 7.5%; p=0.062). More babies in the bolus group were admitted to SCBU (54.1% vs 7.9%; p=0.000). There was no early neonatal death, and no maternal death in the first week of puerperium.
Conclusion: This study showed that hourly bolus intravenous administration of magnesium sulphate is comparable to continuous intravenous therapy in terms of safety and efficacy in the treatment of severe preeclampsia. A larger scale study is recommended to further confirm our findings.
Keywords: safety, efficacy, bolus magnesium sulphate, preeclampsia, University of Benin Teaching Hospital
Trop J Obstet Gynaecol, 30 (1), April 2013
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