A Randomised Control Trial To Compare Efficacy Of 10 Gm Intramuscular Single Loading Dose Mgso4 With Standard Pritchard Regime For Imminent Eclampsia And Eclampsia

Abstract

To study the effectiveness, side effects , maternal and perinatal outcome using 10gm intramuscular single loading dose MgSO4 in comparison with the standard Pritchard regimen in imminent eclampsia and eclampsia. MATERIALS AND METHODS: All cases of Eclampsia (Ante partum / Intrapartum / postpartum ) and Imminent eclampsia (hypertension with headache, epigastric pain, vomiting and blurring of vision) will be included in the study. Cases are divided into two groups , Group I (control) patient's will receive magnesium sulphate by Pritchard regimen and Group II (Study) patients will receive 10 gm i.m. single loading dose magnesium sulphate . Equal number of Cases are allotted into Group I and Group II according to randomization table baring a seed number 29254. Primary outcome measures will be the occurrence of fits in those with imminent eclampsia & further convulsions in patients of eclampsia. Secondary outcome measures will be maternal outcome & fetal outcome (APGAR at 5min of birth & duration of NICU stay). RESULTS: 10 g intramuscular single dose regimen (group II) was successful in preventing occurrence of convulsions prophylactically in imminent eclampsia patients but recurrence of convulsions in eclampsia patients was significantly high x (37% ) in group II compared to standard pritchards regimen( 2.85%) suggesting the need for higher dose. There were no maternal deaths in both the groups. Apgar score at 5 minutes was less in group I and the duration of NICU stay prolonged compared to group II indicating the side effect of higher dose of magnesium sulphate on fetus. CONCLUSION: 10 gm single dose intramuscular dose is as effective as standard regimen in preventing occurrence of convulsion in imminent eclampsia patients prophylactically but the dose is not sufficient enough to prevent recurrence in eclampsia patient.The dose used in our study had efficient secondary outcome measures with comparable maternal outcome and good fetal outcome. Proper selection of the patient for 10 gm single intramuscular dose would avoid the side effects of higher dose on both fetus and mother.