Publication:

Comparison of Pritchard and low dose magnesium sulphate regimen in patients with severe preeclampsia and eclampsia

Background Hypertensive disorders of pregnancy, particularly preeclampsia and eclampsia, remain major contributors to maternal and perinatal morbidity and mortality. Magnesium sulphate (MgSO4) is the drug of choice for seizure prophylaxis and control, but the optimal dosage regimen balancing efficacy and safety remains debated. The aim and objectives of the study were to compare the efficacy, safety, and maternal–fetal outcomes of the standard Pritchard regimen with low-dose MgSO4 regimens (Zuspan and Dhaka) in patients with severe preeclampsia and eclampsia.

Methods A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, M. L. N. Medical College, Prayagraj, over one year, including 150 women diagnosed with severe preeclampsia or eclampsia. Participants were allocated to three groups receiving Pritchard, Zuspan, or Dhaka regimens. Maternal and perinatal outcomes, adverse effects, and recurrence of convulsions were compared using appropriate statistical tests.

Results The recurrence of convulsions was comparable among the three groups (p=0.67). However, adverse effects such as loss of deep tendon reflexes (36.4% versus 10.4% versus 8.5%), decreased urine output (32.7% versus 6.3% versus 4.3%), and respiratory depression (23.6% versus 4.2% versus 2.1%) were significantly higher in the Pritchard group (p<0.05). Maternal and perinatal outcomes, including mortality and neonatal intensive care unit (NICU) admissions, showed no statistically significant differences.

Conclusion Low-dose MgSO4 regimens (Zuspan and Dhaka) are as effective as the Pritchard regimen in controlling eclamptic seizures but have fewer adverse effects, making them safer, more tolerable, and cost-effective, especially in resource-limited settings.