Comparison of intramuscular magnesium sulfate with low dose intravenous magnesium sulfate regimen for treatment of eclampsia.

OBJECTIVES

Our objective was to compare intramuscular (i.m.) magnesium sulfate with a low dose intravenous (i.v.) magnesium sulfate regimen in prevention of convulsion recurrence and maternal deaths in women with eclampsia.

METHODS

This prospective trial was conducted in Nilratan Sircar Medical College, India from January 2001 to December 2005. All women with a clinical diagnosis of eclampsia were included in the trial. Magnesium sulfate (4 gm) was given as an i.v. loading dose, followed by either i.m. injections as recommended by Pritchard or low dose i.v. infusions (0.6 gm/h). Primary measures of outcome were recurrence of convulsions and maternal death. Secondary measures of outcome were potentially life threatening events, events related to labor and delivery as well as perinatal mortality and morbidity.

RESULTS

Of the 630 women participating in the trial, 480 women received i.m. magnesium sulphate according to the Pritchard regimen and 150 women were subjected to a low dose i.v. regimen of magnesium sulphate. There was no significant difference in recurrence of convulsion (3.3% in the i.m. and 2% in the i.v. groups P = 0.586). Maternal deaths were not significantly lower in the i.v. group than the i.m. group (5% in the i.m. and 3.3% in the i.v. groups, P = 0.506) There were no significant differences in other measures of serious maternal morbidity, in perinatal morbidity or mortality.

CONCLUSION

Low dose i.v. magnesium sulfate regimen is equally effective in prevention of convulsion recurrence and maternal deaths in eclamptic women when compared with an i.m. magnesium sulfate regimen.