Intravenous magnesium sulfate in the management of severe pre‐eclampsia: A randomized study of 12‐hour versus 24‐hour maintenance dose

Abstract

Objective To assess the effectiveness of a 12‐hour versus 24‐hour intravenous maintenance dose of magnesium sulfate (MgSO4) in women with pre‐eclampsia, and the maternal and fetal outcomes. Methods This was a randomized controlled trial conducted at the labor ward complex of University College Hospital, Ibadan, Nigeria between May and August 2014. Pregnant women with severe pre‐eclampsia were randomized to receive a 12‐hour versus 24‐hour maintenance dose of MgSO4. Study outcomes were occurrence of seizures, adverse maternal effects, neonatal survival, and admission to the intensive care unit. Data analysis involved descriptive statistics and bivariate analysis using Statistical Package for Social Science (SPSS) version 20. Results There were 80 patients randomized to the 12‐hour (n=40) and 24‐hour (n=40) groups. The participants in the two groups had comparable demographic features. There was no significant difference (P>0.999) between the satisfactory maternal outcome following the 12‐hour maintenance dose and the standard 24‐hour regimen (95.0% vs 97.5%). Similarly, there was no significant difference (P=0.276) in perinatal mortality in the 12‐hour versus 24‐hour arm (17.5% vs 12.5%, respectively). No case of eclampsia and maternal death was recorded. Conclusion A 12‐hour maintenance dose of intravenous MgSO4 in the management of severe pre‐eclampsia is effective and safe when compared with the 24‐hour maintenance dose.

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

“…No individual trial demonstrated a difference in the outcome of seizure between groups; however, the number of participants in each study was small. Another small study in Nigeria 28 ( n = 80) also compared 12‐h versus 24‐h regimens, with no seizure events in either group. Our study adds substantially to this literature due to our large sample size, which exceeds the combined participants of the meta‐analysis.…”

Duration of Postpartum Magnesium Sulphate for the Prevention of Eclampsia

“…18 The other analysis, by Sullivan et al, included RCTs with women with preeclampsia and identified nine articles; six were included in our study, and three were excluded (one for high risk of bias, one study reported the total time on magnesium sulphate that included the antepartum time and therefore lacked a group exposed to 24 hours of magnesium sulphate postpartum, and one trial included an experimental group that received different durations of postpartum magnesium sulphate). 8,[19][20][21] We therefore feel that our study is more comprehensive and clinically useful, because we included every trial including preeclampsia or eclampsia.…”

Intoxicación con Sulfato de Magnesio en Preeclampsia y Eclampsia

“…Unwaha et al, en el 2020 en su estudio retrospectivo, analizo 80 gestantes en las que encontró hiporreflexia en el 52% y debilidad muscular en el 60%, con valor de P <0,01 lo que nos indica que es estadísticamente significativo (49). Saha et al, en el 2017 en su estudio prospectivo, analizo 50 gestantes en las que encontró únicamente hiporreflexia en el 65% con valor de P <0,01 lo que nos indica que es estadísticamente significativo (50).…”