Eclampsia--management and outcome with magnesium sulphate as the anticonvulsant.

OBJECTIVE

To study the maternal outcome in terms of morbidity and mortality with the use of magnesium sulphate in eclampsia for seizure control and prophylaxis.

DESIGN

A quasi experimental study.

PLACE AND DURATION OF STUDY: This study was conducted in Obstetrics and Gynaecology Unit of Hayatabad Medical Complex, Peshawar, from 1st September 2002 to 31st December 2003.

PATIENTS AND

METHODS

All the patients admitted with eclampsia during this period were included in the study. A detailed history and clinical examination were recorded. Patients were monitored for number of fits, rise in blood pressure (BP), dose of magnesium sulphate administered and its side effects, development of complications of eclampsia, duration of labour, mode of delivery and use of other medications as well as maternal and perinatal outcome.

RESULTS

During this period, 52 patients were admitted with eclampsia. Majority were unbooked. Primigravida were 31 (59.6%). Common age group was between 21 and 30 years having 34 (65.4%) patients while 16 (30.7%) patients were 20 years or less than 20 years of age. Thirty-three (63.4%) patients had antenatal fits, 9 (17.3%) intrapartum fits and 11 (19.2%) had postpartum eclampsia. Twenty-six patients had term pregnancy, 22 patients with 28-36 weeks gestation while 4 patients developing eclampsia before 28 weeks gestation. Eighteen patients had spontaneous vaginal delivery; labour was induced in 21 patients while 6 patients underwent cesarean section. Maternal complications included pulmonary oedema, tongue bites, HELLP syndrome, placental abruption and coagulopathy. Side effects of magnesium sulphate were low. There were 4 (7.6%) maternal deaths due to eclampsia. Perinatal outcome was good with 33 (63.4%) live births, 3 IUDs and 10 still births, mostly due to prematurity.

CONCLUSION

Magnesium sulphate was found to be an effective anti-convulsant both for control and prophylaxis of seizures in eclampsia and improved maternal and fetal outcome.