Magnesium sulphate versus phenytoin in eclampsia – Maternal and foetal outcome –

Roy, Jayeeta; Mitra, Jayanta Kumar

doi:10.4066/amj.2013.1753

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…The management of patients with common complications of pregnancy received attention from Roy et al 15 in their review of treatment with magnesium sulphate compared to phenytoin in eclampsia. In a randomised trial 80 women with eclampsia were randomised to receive either magnesium sulphate or phenytoin.…”

Section: Maternal Healthmentioning

confidence: 99%

A reflection on current obstetrics and gynaecology research in India

Pacheco-Páramo¹,

Cornwall

2013

AMJ

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Section: Maternal Healthmentioning

confidence: 99%

A reflection on current obstetrics and gynaecology research in India

Pacheco-Páramo¹,

Cornwall

2013

AMJ

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Time and sex dependent effects of magnesium sulphate on post‐asphyxial seizures in preterm fetal sheep

Bennet

Galinsky

Draghi

et al. 2018

The Journal of Physiology

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Seizures are common in newborns after asphyxia at birth and are often refractory to anti-seizure agents. Magnesium sulphate (MgSO ) has anticonvulsant effects and is increasingly given to women in preterm labour for potential neuroprotection. There is limited information on its effects on perinatal seizures. We examined the hypothesis that MgSO infusion would reduce fetal seizures after asphyxia in utero. Preterm fetal sheep at 0.7 gestation (104 days, term = 147 days) were given intravenous infusions of either saline (n = 14) or MgSO (n = 12, 160 mg bolus + 48 mg h infusion over 48 h). Fetuses underwent umbilical cord occlusion (UCO) for 25 min, 24 h after the start of infusion. The start time for seizures did not differ between groups, but MgSO significantly reduced the total number of seizures (P < 0.001), peak seizure amplitude (P < 0.05) and seizure burden (P < 0.005). Within the saline-asphyxia group, male fetuses had significantly more seizures than females (P < 0.05). Within the MgSO -asphyxia group, although both sexes had fewer seizures than the saline-asphyxia group, the greatest effect of MgSO was on male fetuses, with reduced numbers of seizures (P < 0.001) and seizure burden (P < 0.005). Only 1 out of 6 MgSO males had seizures on the second day post-UCO compared to 5 out of 6 MgSO female fetuses (P = 0.08). Finally, seizures showed a circadian profile with peak seizures between 04.00 and 06.00 h on the first and second day post-UCO. Collectively, these results suggest that MgSO may have utility in treating perinatal seizures and has sexually dimorphic effects.

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Recurrent Seizures in 2 Patients with Magnesium Sulfate-Treated Eclampsia at a Secondary Hospital

Harsono

Achmadi²,

Akbar

et al. 2018

Am J Case Rep

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Case seriesPatient: Female, 20 • Female, 19Final Diagnosis: Recurrent seizure eclampsiaSymptoms: Hypertension • seizureMedication: —Clinical Procedure: Magnesium sulfate therapySpecialty: Obstetrics and GynecologyObjective:Unusual clinical courseBackground:Recurrent seizure in patients with magnesium sulfate-treated eclampsia is very rare and requires meticulous management due to poor prognosis. The development of eclamptic convulsions is considered a preventable obstetric situation. Magnesium sulfate has been the drug of choice in such cases. However, some cases are persistent and need more aggressive treatment.Case Report:First case: A 20-year-old, nulliparous woman was referred from a private midwifery practice with history of convulsion, 40 weeks of gestational age (GA), and in the active phase of labor. She had been treated with magnesium sulfate and nifedipine beforehand. Her fetus was tachycardic, so an emergency caesarean section was done and placental abruption was found. The day after the surgery, the patient had recurrent seizures despite receiving a maintenance dose of magnesium sulfate. The patient then received thiopental sodium and remained stable.Second case: A 19-year-old, nulliparous woman came to the hospital with 40 weeks of GA, prolonged premature rupture of the membrane (PROM), preeclampsia, and cephalopelvic disproportion (CPD). An emergency caesarean section was performed. Eighteen hours after surgery, the patient had convulsions despite receiving magnesium sulfate maintenance therapy. We repeated the loading dose of 2 g magnesium sulfate, but the seizures persisted. Hence, midazolam was given and the seizures remained controlled. Both babies were delivered without any significant complications.Conclusions:We report 2 cases of GIP0-0 women with 40 weeks GA who had magnesium sulfate-resistant eclampsia and needed additional anticonvulsant drugs. These cases show the importance of comprehensive management and the need for alternative drugs in eclampsia.

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Magnesium sulphate versus phenytoin in eclampsia – Maternal and foetal outcome –

Cited by 3 publications

References 34 publications

A reflection on current obstetrics and gynaecology research in India

A reflection on current obstetrics and gynaecology research in India

Time and sex dependent effects of magnesium sulphate on post‐asphyxial seizures in preterm fetal sheep

Recurrent Seizures in 2 Patients with Magnesium Sulfate-Treated Eclampsia at a Secondary Hospital

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