Experience of a low-dose magnesium sulfate regimen for the management of eclampsia over a decade

ObjectiveTo assess the safety and efficacy of a low-dose magnesium sulfate regimen for the management of eclampsia in Indian women.MethodsA loading dose consisting of 3 g of magnesium sulfate intravenously plus 5 g intramuscularly (2.5 g in each buttock) was followed by 2.5 g intramuscularly every 4 hours, for 24 hours beyond the last seizure. In a first phase, which spanned 2001 and 2002, the regimen was evaluated prospectively with 554 women with eclampsia, and the results were compared with results from the Collaborative Eclampsia Trial. Regarding the second phase, which spanned the 9 following years, mortality was analyzed retrospectively for 2929 women treated by the same regimen at the same hospital.ResultsThe mean ± SD maternal weight and height were 41.7 ± 5.3 kg and 151 ± 7 cm, respectively. The low-dose regimen was associated with a lower seizure recurrence (6.1% vs 9.7%; P = 0.02) and a slightly lower maternal mortality (2.7% vs 3.2%; P = 0.6) compared with the Collaborative Eclampsia Trial. The overall case fatality rate for the second phase was 3.3%.ConclusionThe low-dose regimen was safe and effective for the management of eclampsia in a region where most women are of light weight.