Comparative Study of the Standard Pritchard Regimen and Low Dose Dhaka Regimen of Magnesium Sulphate in the Management of Severe Preeclampsia and Eclampsia
Authors/Creators
- 1. Associate Professor, Department of Obstretrics and Gynecology, Andhra Medical College, Vishakapatnam
- 2. Assistant Professor, Department of Obstretrics and Gynecology, SVMC, Tirupathi
- 3. Senior Resident, Department of Obstetrics and Gynecology, Apollo Medical College, Jubilee Hills, Hyderabad
Description
Background: Pre eclampsia and eclampsia are responsible for more than 50,000 maternal fatalities worldwide. Controlling convulsions is the first rule in the treatment of eclampsia. Magnesium sulphate is the anticonvulsant medication of choice for both preventing and treating eclampsia, but its toxicities are dose-related, which is a serious issue. In many low-income nations, the medicine is only sometimes used due to unwarranted concern over these risks. Reducing the toxicity of magnesium sulphate without sacrificing its effectiveness in preventing seizures and reducing mortality rates is still a difficult task. Aim of the study: To study the effectiveness of low dose Magnesium sulphate Regimen- Dhaka Regimen in Eclampsia and to compare the effects of Standard regimen (Pritchard) to low dose regimen (Dhaka). Materials & Methods: This was a Prospective Clinical Study, Government Maternity Hospital attached to SVMC, Tirupati done in 200 pregnant women with severe pre-eclampsia, imminent eclampsia & eclampsia attending to Govt Maternity Hospital, Tirupati for a period of one year. Results: Unbooked cases of Pritchard regimen group were 94% and Dhaka regimen were 89%. Most of the cases were primigravida (67.5%). 44% were above 37 weeks. Level of consciousness of the patients in the 2 groups not differs significantly. No significant differences between 2 groups in number of convulsions before admission. Majority of the cases in both groups have SBP >160 mm Hg and Majority of the cases have DBP of 100-110 mm Hg. Out of 100 cases in Dhaka regimen group, 17 cases were augmented with oxytocin, 19 cases with PGE2, 57 cases with misoprostol. Conclusion: In women with eclampsia, magnesium sulphate is the anticonvulsant medication of choice. For smaller women, the Dhaka Regimen at a low dose appears to effectively regulate and avoid seizures. The current study offers more convincing evidence in favor of using magnesium sulphate frequently to treat eclampsia convulsions. Clinical surveillance seems suitable as long as there is enough urine output. There is no difference between the two magnesium sulphate regimens in terms of maternal mortality, perinatal death, maternal morbidity, or caesarean section rates.
Abstract (English)
Background: Pre eclampsia and eclampsia are responsible for more than 50,000 maternal fatalities worldwide. Controlling convulsions is the first rule in the treatment of eclampsia. Magnesium sulphate is the anticonvulsant medication of choice for both preventing and treating eclampsia, but its toxicities are dose-related, which is a serious issue. In many low-income nations, the medicine is only sometimes used due to unwarranted concern over these risks. Reducing the toxicity of magnesium sulphate without sacrificing its effectiveness in preventing seizures and reducing mortality rates is still a difficult task. Aim of the study: To study the effectiveness of low dose Magnesium sulphate Regimen- Dhaka Regimen in Eclampsia and to compare the effects of Standard regimen (Pritchard) to low dose regimen (Dhaka). Materials & Methods: This was a Prospective Clinical Study, Government Maternity Hospital attached to SVMC, Tirupati done in 200 pregnant women with severe pre-eclampsia, imminent eclampsia & eclampsia attending to Govt Maternity Hospital, Tirupati for a period of one year. Results: Unbooked cases of Pritchard regimen group were 94% and Dhaka regimen were 89%. Most of the cases were primigravida (67.5%). 44% were above 37 weeks. Level of consciousness of the patients in the 2 groups not differs significantly. No significant differences between 2 groups in number of convulsions before admission. Majority of the cases in both groups have SBP >160 mm Hg and Majority of the cases have DBP of 100-110 mm Hg. Out of 100 cases in Dhaka regimen group, 17 cases were augmented with oxytocin, 19 cases with PGE2, 57 cases with misoprostol. Conclusion: In women with eclampsia, magnesium sulphate is the anticonvulsant medication of choice. For smaller women, the Dhaka Regimen at a low dose appears to effectively regulate and avoid seizures. The current study offers more convincing evidence in favor of using magnesium sulphate frequently to treat eclampsia convulsions. Clinical surveillance seems suitable as long as there is enough urine output. There is no difference between the two magnesium sulphate regimens in terms of maternal mortality, perinatal death, maternal morbidity, or caesarean section rates.
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Additional details
Dates
- Accepted
-
2024-03-26
Software
References
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