Rimal Surya Prasad, Rijal Pappu, Bhatt Rabindra, Thapa Kriti
Department of Obstetrics and Gynaecology, BP Koirala Institute of Health Sciences, Dharan, Nepal.
Department of Psychiatry Nursing, BP Koirala Institute of Health Sciences, Dharan, Nepal.
JNMA J Nepal Med Assoc. 2017 Oct-Dec;56(208):388-94.
Magnesium sulfate is the drug of choice for prevention of seizures in the pre-eclamptic woman. There is no agreement in the published randomized trials regarding the optimal time to initiate magnesium sulfate, the dose to use (both loading and maintenance) as well as the duration of therapy. The objective of this study is to determine whether magnesium sulfate prophylaxis is needed for up to 24 hours postpartum in all patients with severe pre-eclampsia for the prevention of seizure.
It is a randomized controlled trial conducted on 60 pregnant women with severe preeclampsia randomized into standard dose and loading dose only regimen.
Out of 30 cases in each group 1 (3.3%) patient in standard regimen and 2 (6.7%) patients in loading dose only developed seizure. The occurrence of seizure is not significant statistically. In both regimens, there was no maternal mortality. Total of 3 patients needed MICU care and 12 patient developed maternal complications. MgSO4 toxicities were seen only in standard dose regimen that is in 17 (56.7%) of the patients. The median number of IM injections of MgSO4 received in standard dose regimen was 8±2.176. In standard dose regimen 73.3 percent baby were alive whereas in case of loading dose only regimen 93.3 percent of baby were alive after 48 hours of delivery.
Single dose of magnesium sulfate is equally effective as standard dose regimen in terms of seizure prophylaxis in severe pre eclamptic women, with added advantage of reduced maternal toxicity and better neonatal outcome.
硫酸镁是预防子痫前期女性惊厥的首选药物。在已发表的随机试验中，对于开始使用硫酸镁的最佳时间、使用剂量（负荷剂量和维持剂量）以及治疗持续时间尚无共识。本研究的目的是确定所有重度子痫前期患者产后24小时内预防惊厥是否需要使用硫酸镁进行预防。
这是一项对60例重度子痫前期孕妇进行的随机对照试验，随机分为标准剂量组和仅使用负荷剂量组。
每组30例患者中，标准治疗方案组有1例（3.3%）患者发生惊厥，仅使用负荷剂量组有2例（6.7%）患者发生惊厥。惊厥发生率在统计学上无显著差异。在两种治疗方案中，均无孕产妇死亡。共有3例患者需要重症监护病房护理，12例患者出现孕产妇并发症。仅在标准剂量组观察到硫酸镁毒性，有17例（56.7%）患者出现该情况。标准剂量组硫酸镁肌内注射的中位数为8±2.176次。在标准剂量组，73.3%的婴儿存活；而在仅使用负荷剂量组，分娩48小时后93.3%的婴儿存活。
在预防重度子痫前期女性惊厥方面，单剂量硫酸镁与标准剂量方案同样有效，且具有降低母体毒性和改善新生儿结局的额外优势。
