Publication:

Comparison between intramuscular and intravenous regimen of magnesium sulfate in management of severe preeclampsia and eclampsia

Background Objective of current study was to compare between intramuscular (IM) and intravenous (IV) magnesium sulfate regimen in terms of efficacy, side effects, maternal and fetal outcome.

Methods A prospective study was performed on 82 patients from September 2008 to January 2010 and comparison was made between IV and IM group, each group consisting of 17 patients of eclampsia and 24 patients of severe preeclampsia. IV group received continuous IV magnesium sulfate (IV MgSO4) consisting of 4gm of loading dose, administered over 15 minutes followed by maintenance dose of 2gm/hour. The IM group received intramuscular magnesium sulfate (IM MgSO4) according to Pritchard regimen.

Results Recurrence of convulsion in was found in 1/17 (5.88%) of eclamptic patients in IV and 1/17 (5.88%) in IM group which is statistically not significant (P = 1).There was no occurrence of convulsion in any of the cases having severe eclampsia in either group. There was statistically no significant difference in maternal death between the two groups   (IM = 1/41(2.43%) and no mortality in IV group, P = 0.314). Statistically higher incidence (P = 0.034) of sign of impending toxicity such as loss of patellar reflex was seen in IM group as compared to IV group. Other signs of toxicity such as oliguria, respiratory rate depression though more in IM group, were statistically insignificant. There were no significant differences in other measures of serious maternal morbidity, in perinatal morbidity or mortality.

Conclusions Both the groups are comparable in terms of control and prevention of recurrence of convulsions, maternal and perinatal morbidity and mortality.