Nagaria Tripti, Mitra Subarna, Banjare Sashi Prabha
Professor, Department of Obstetrics and Gynaecology, Pt. Jawaharlal Nehru Medical College and Hospital, Raipur, Chhattisgarh, India.
Assistant Professor, Department of Obstetrics and Gynaecology, Pt. Jawaharlal Nehru Medical College and Hospital, Raipur, Chhattisgarh, India.
J Clin Diagn Res. 2017 Aug;11(8):QC08-QC12. doi: 10.7860/JCDR/2017/26635.10453. Epub 2017 Aug 1.
Magnesium sulphate is the anticonvulsant of choice in prevention and control of eclamptic convulsions. Pritchard's regimen is the most popular time-tested regimen used. However, owing to concerns of toxicity, several low dose regimens have been introduced considering the lower body mass index of Asian women.
To compare the efficacy and safety of a single loading low dose MgSo regimen with the Pritchard's regimen.
Seventy cases of eclampsia and imminent eclampsia were allocated to the control and study groups each. The former received the Pritchard's regimen while the latter was treated with single loading low dose of magnesium sulphate. Recurrent convulsion rates, maternal and perinatal outcomes of both regimens were evaluated and compared using unpaired t-test and Chi-square test for continuous and categorical variables, respectively.
The mean serum magnesium levels were significantly lower in the study group at 30 minutes and 4 hours of initiation of therapy. The single loading low dose regimen was equally efficacious in prevention (96.6% vs 100%, p = 0.934) and control (97.6% vs 97.8%, p = 0.358) of eclamptic fits as compared to the Pritchard's regimen. The feto-maternal outcomes were also comparable.
The single loading low dose MgSo regimen is an effective and safe alternative to the Pritchard's regimen, especially tailored to the small built Indian women.
硫酸镁是预防和控制子痫抽搐的首选抗惊厥药物。普里查德方案是最常用且经过时间检验的方案。然而,由于对毒性的担忧,考虑到亚洲女性较低的体重指数,已引入了几种低剂量方案。
比较单次负荷低剂量硫酸镁方案与普里查德方案的疗效和安全性。
将70例子痫和先兆子痫患者分别分配至对照组和研究组。前者接受普里查德方案治疗,而后者接受单次负荷低剂量硫酸镁治疗。分别使用独立样本t检验和卡方检验对两种方案的复发抽搐率、孕产妇和围产儿结局进行评估和比较,连续变量和分类变量分别采用这两种检验方法。
在治疗开始30分钟和4小时时,研究组的平均血清镁水平显著较低。与普里查德方案相比,单次负荷低剂量方案在预防(96.6%对100%,p = 0.934)和控制(97.6%对97.8%,p = 0.358)子痫发作方面同样有效。母婴结局也相当。
单次负荷低剂量硫酸镁方案是普里查德方案的一种有效且安全的替代方案,尤其适用于身材瘦小的印度女性。