A randomised controlled trial of mgso4 therapy for 24 hours versus early cessation in patients with severe preeclampsia

Introduction: Magnesium sulphate has been shown to be the optimal anticonvulsant in preventing the recurrence of seizures in eclampsia and in seizure prophylaxis in preeclampsia. Traditionally, seizure prophylaxis has been administered before delivery and continued postpartum for an arbitrary time,...

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Bibliographic Details
Main Author: Yunus, Affendi
Format: Thesis
Language:English
Published: 2010
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Online Access:http://eprints.usm.my/37752/1/Pages_from_Affendi_Yunus.pdf
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Summary:Introduction: Magnesium sulphate has been shown to be the optimal anticonvulsant in preventing the recurrence of seizures in eclampsia and in seizure prophylaxis in preeclampsia. Traditionally, seizure prophylaxis has been administered before delivery and continued postpartum for an arbitrary time, usually 24 hours. Objectives: The primary objectives of this study were to evaluate the safety and effectiveness of using clinical parameters to signal cessation of postpartum magnesium sulphate therapy among patients with Severe Preeclampsia. Methodology: A randomized trial of postpartum magnesium sulphate therapy was conducted in HRPZII, Kota Bharu and HUSM, Kubang Kerian from December 2009 to September 2010. The control group received 24 hours of therapy, and the intervention group received therapy until fulfilled clinical criteria for discontinuation of seizure prophylaxis. The Independent t test, Chi-square test, and Fisher’s exact test were used for analysis of data. A probability value of <0.05 was considered statistically significant. Results: There were 52 patients in the control group and 50 patients in the intervention group. The intervention group had a significantly shorter duration of therapy (p< 0.05). There were no differences in mean booking BMI, weight on admission, systolic blood pressure and platelet level between two groups. However there were significance differences in mean age of the patients, delivery gestational age, diastolic blood pressure and uric acid level between two groups. There was no patient in this study had eclampsia or required the reinitiation of therapy. Conclusions: Clinical parameters can be used effectively and safe to shorten the duration of postpartum magnesium sulphate therapy in patients with severe preeclampsia.