Evaluation of effects of patient characteristics on shorter regimens of magnesium sulphate administration in patients with severe preeclampsia – a randomised clinical trial

In developing nations like India, pre-eclamspia and eclampsia contribute significantly to maternal mortality. Magnesium Sulphate is the drug of choice to control seizures in eclampsia, and prevent convulsions in severe preeclampsia. Pritchard regimen, which involves administration of MgSO4 for twenty-four hours till after delivery (or last fit), is the preferred regimen in low resource settings, though the side effects and concerns about toxicity of Magnesium Sulphate makes it advantageous to explore shorter regimens. We conducted a randomised prospective clinical trial study on 100 patients with either severe PET, signs of impending eclampsia, or HELLP syndrome. Patients were grouped into three groups of single dose post-partum (Group I), dosage for 12 hour post-partum (Group II), and dosage for 24 hours post-partum (Group III). The clinical outcomes such as time to return to ambulation, duration of indwelling catheter, time until contact with new born, and whether the mother breastfed within one hour were compared based on patient BMI, the mode of delivery, and whether the delivery was preterm. Only patients in Group II and III showed signs of MgSO4 toxicity. Patients who had pre-term deliveries and patients who underwent caesarean section showed higher rate of adverse effects, higher time to return to ambulation, longer duration of indwelling catheter.