Magnesium sulphate and other anticonvulsants for women with pre-eclampsia

Duley, Lelia; Gülmezoglu, A. Metin; Henderson‐Smart, David J; Chou, Doris

doi:10.1002/14651858.cd000025.pub2

Cited by 276 publications

(192 citation statements)

References 80 publications

(18 reference statements)

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“…28 Six known effective interventions to reduce MM or SMM were selected for analysis (see, Figure S4). [29][30][31][32][33][34][35] World Health Organization classifications were used for outcomes and operational definitions (see Figure S5). 6,28,[36][37][38] …”

Section: Outcome Measurement Definitions and Statistical Analysismentioning

confidence: 99%

The epidemiology of life‐threatening complications associated with reproductive process in public hospitals in Argentina

Karolinski¹,

Mercer

Micone

et al. 2013

BJOG

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Objective To analyse life-threatening obstetric complications that occurred in public hospitals in Argentina.Design Multicentre collaborative cross-sectional study.Setting Twenty-five hospitals included in the Perinatal Network of Buenos Aires Metropolitan Area.Population Women giving birth in participating hospitals during a 1-year period.Methods All cases of severe maternal morbidity (SMM) and maternal mortality (MM) during pregnancy (including miscarriage and induced abortion), labour and puerperium were included. Data were collected prospectively.Main outcome measures Identification criteria, main causes and incidence of SMM; case-fatality rates, morbidity-mortality index and effective intervention's use rate.Results A total of 552 women with life-threatening conditions were identified: 518 with SMM, 34 with MM. Identification criteria for SMM were case-management (48.9%), organ dysfunction (15.2%) and mixed criteria (35.9%). Incidence of SMM was 0.8% (95% confidence interval [95% CI] 0.73-0.87%) and hospital maternal death ratio was 52.3 per 100 000 live births (95% CI 35.5-69.1). Main causes of MM were abortion complications and puerperal sepsis; main causes of SMM were postpartum haemorrhage and hypertension. Overall case-fatality rate was 6.2% (95% CI 4.4-8.6): the highest due to sepsis (14.8%) and abortion complications (13.3%). Morbidity-mortality index was 15:1 (95% CI 7.5-30.8). Use rate of known effective interventions to prevent or treat main causes of MM and SMM was 52.3% (95% CI 46.9-57.7).Conclusions This study describes the importance of life-threatening obstetric complications that took place in public hospitals with comprehensive obstetric care and the low utilisation of known effective interventions that may decrease rates of SMM and MM. It also provides arguments that justify the need to develop a surveillance system for SMM.

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Section: Outcome Measurement Definitions and Statistical Analysismentioning

confidence: 99%

The epidemiology of life‐threatening complications associated with reproductive process in public hospitals in Argentina

Karolinski¹,

Mercer

Micone

et al. 2013

BJOG

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“…Although delivery remains the ultimate treatment for preeclampsia, [38, 39] magnesium sulfate is the drug of choice for preventing eclamptic seizures and also has the additional benefit of reducing the incidence of placental abruption [40, 41]. Occasionally, the administration of magnesium sulfate results in an accidental overdose leading to respiratory paralysis, central nervous system depression and cardiac arrest.…”

Section: Introductionmentioning

confidence: 99%

Quality medicines in maternal health: results of oxytocin, misoprostol, magnesium sulfate and calcium gluconate quality audits

Anyakora

Oni

Ezedinachi

et al. 2018

BMC Pregnancy Childbirth

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BackgroundThe high level of maternal mortality and morbidity as a result of complications due to childbirth is unacceptable. The impact of quality medicines in the management of these complications cannot be overemphasized. Most of those medicines are sensitive to environmental conditions and must be handled properly. In this study, the quality of oxytocin injection, misoprostol tablets, magnesium sulfate, and calcium gluconate injections was assessed across the six geopolitical zones of Nigeria.MethodSimple, stratified random sampling of health facilities in each of the political zones of Nigeria. Analysis for identification and content of active pharmaceutical ingredient was performed using high-performance liquid chromatography procedures of 159 samples of oxytocin injection and 166 samples of misoprostol tablets. Titrimetric methods were used to analyze 164 samples of magnesium sulfate and 148 samples of calcium gluconate injection. Other tests included sterility, pH measurement, and fill volume.ResultsSamples of these commodities were procured mainly from wholesale and retail pharmacies, where these were readily available, while the federal medical centers reported low availability. Approximately, 74.2% of oxytocin injection samples failed the assay test, with the northeast and southeast zones registering the highest failure rates. Misoprostol tablets recorded a percentage failure of 33.7%. Magnesium sulfate and Calcium gluconate injection samples recorded a failure rate of 6.8% and 2.4%, respectively.ConclusionThe prevalence of particularly of oxytocin and misoprostol commodities was of substandard quality. Strengthening the supply chain of these important medicines is paramount to ensuring their effectiveness in reducing maternal deaths in Nigeria.

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“…Magnesium sulfate is recommended as prophylaxis for eclampsia in patients with severe preeclampsia 15. However, it is well recognised that magnesium can precipitate a myasthenic crisis,6 16 and is contraindicated for use as eclampsia prophylaxis in myasthenia 6 9 17.…”

Section: Discussionmentioning

confidence: 99%

New diagnosis myasthenia gravis and preeclampsia in late pregnancy

2015

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SUMMARYMyasthenia gravis is a chronic autoimmune disease of neuromuscular transmission resulting in fatigable skeletal muscle weakness. Preeclampsia is a multisystem disease of pregnancy which is characterised by hypertension and involvement of one or more organ systems. Both diseases are responsible for considerable morbidity and mortality for mother and fetus. The occurrence of both preeclampsia and myasthenia gravis in pregnancy is very rare, and conflicts arise when considering the optimal management of each disease.We present a case of a parturient who was newly diagnosed with both myasthenia gravis and preeclampsia in late pregnancy. Myasthenia treatment was started with prednisolone and pyridostigmine, and delivery was by caesarean section at 37 weeks gestation under spinal anaesthesia. Postnatally, the patient developed worsening of myasthenia and preeclampsia symptoms. We consider the anaesthetic implications for both diseases and describe our approach for the management of this case. BACKGROUND

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Magnesium sulphate and other anticonvulsants for women with pre-eclampsia

Abstract: Magnesium sulphate and other anticonvulsants for women with pre-eclampsia (Review)

Cited by 276 publications

References 80 publications

The epidemiology of life‐threatening complications associated with reproductive process in public hospitals in Argentina

The epidemiology of life‐threatening complications associated with reproductive process in public hospitals in Argentina

Quality medicines in maternal health: results of oxytocin, misoprostol, magnesium sulfate and calcium gluconate quality audits

New diagnosis myasthenia gravis and preeclampsia in late pregnancy

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