12-Hour Compared With 24-Hour Postpartum Magnesium Sulfate Therapy in Preeclampsia

Abstract

factors for perineal lacerations requiring suture in vaginal deliveries without episiotomy. METHODS:We conducted a prospective cohort study including 400 vaginal deliveries assisted in a public hospital in Brazil. During the second stage of labor, maneuvers as such directed pushing, fundal pressure, and Valsalva maneuver were avoided. A policy of no episiotomy was followed with strategies for perineal protection that included warm compresses and intrapartum perineal massage. We calculated the relative risk and its 95% confidence interval (95% CI). Multivariate analysis was performed to determine the adjusted risk of need for suture. RESULTS:We analyzed 400 women who had vaginal deliveries with no episiotomy and 6% of instrumental deliveries. The rate of perineal lacerations in primiparous (210) was 56.7% and in multiparous (190) 30%. Suture was necessary in 23% of women (30% of primiparous and 15.3% of multiparous). In multivariate analysis, the factors that remained associated with increased risk of need for suture were primiparity (adjusted risk 1.81, 95% CI 1.25-2.89) and instrumental delivery (adjusted risk 3.78, 95% CI 1.21-18.66).CONCLUSION: There was a reduced need for suture in vaginal deliveries with the application of a protocol of perineal protection and no episiotomy. Primiparity and instrumental delivery were associated with increased risk of need for suture.Financial Disclosure:

A novel 12‐hour versus 24‐hour magnesium sulfate regimen in the management of eclampsia and preeclampsia in Ghana (MOPEP Study): A randomized controlled trial

“…23 There were only two events of eclampsia reported across the trials, both occurring in the shortened regimen arm (risk difference 0.00, 95% CI -0.01-0.01, P = 0.49). This meta-analysis included four RCTs conducted in Brazil, 24 Iran, 25,26 and Egypt 27 specifically comparing 12-h to 24-h regimens, with a total study population of 562. No individual trial demonstrated a difference in the outcome of seizure between groups; however, the number of participants in each study was small.…”