A TERTIARY CENTER'S EXPERIENCE COMPARING THE USUAL PRITCHARD REGIME WITH A LOW DOSE MAGNESIUM SULPHATE REGIME FOR SEVERE PREECLAMPSIA AND ECLAMPSIA: A CROSS-SECTIONAL STUDY.

Rameshwari  Beck; Jyoti  Hosamani

doi:10.51168/sjhrafrica.v4i12.920

Authors

Rameshwari Beck Assistant Professor, Department of Obstetrics & Gynaecology, Sheikh Bhikhari Medical College & Hospital, Hazaribagh, Jharkhand, India
Jyoti Hosamani Senior Resident, Department of Obstetrics and Gynaecology, Sheikh Bhikhari Medical College & Hospital, Hazaribagh, Jharkhand, India

DOI:

https://doi.org/10.51168/sjhrafrica.v4i12.920

Keywords:

Pre-eclampsia, Eclampsia, Magnesium sulphate, Pritchard regimen, Convulsions

Abstract

Background

The study's objective was to ascertain whether skipping the intravenous (IV) loading dosage of magnesium sulphate would have an equivalent effect to the conventional loading dose (intramuscular + intravenous) in eclampsia for the purpose of preventing convulsions.

Methods

Patients were randomly assigned to two groups. Group A (modified Pritchard protocol) received an IM loading dose of MgSo₄ and a 12-hour maintenance dose instead of IV. Group B got the standard Pritchard regimen, including IV and IM loading doses and 24-hour maintenance dosages. To see if the adapted Pritchard protocol performed as well as the original.

Results

The two regimens had similar age, parity, gestational age at presentation, and birthing methods. Participants in groups A and B with pre-eclampsia (PE) or eclampsia achieved the therapeutic range of MgSo₄ after an hour after loading dose, with group A having a lower toxicity risk (because the IV dose was missed). Recurrent convulsions occurred in 5 (19.6%) of group A and 9 (29.4%) of group B of 62 eclampsia patients. Both groups of severe PE women had no seizures after MgSO₄ loading.

Conclusions

Given the reduced propensity for MgSo₄ toxicity, the 12-hour maintenance dose and the reduced loading dose regimen—which do not include the IV loading dose—of MgSo₄ are as effective as the full loading dose and the 24-hour maintenance regimen in the standard Pritchard regimen in managing convulsion and preventing recurrent convulsion in eclampsia and severe pre-eclampsia.

Recommendations

According to the study, the revised Pritchard protocol for eclampsia proposes lowering IV MgSo₄infusion. Maintenance with lower loading dosages for 12 hours and IV loading doses for 24 hours prevents seizures. Since MgSo₄ is less toxic, it can prevent and cure convulsions in eclampsia and severe pre-eclampsia. Clinical use and evaluation of this improved approach may improve at-risk pregnancy care.