Abstract

Eclampsia is a serious obstetric condition, resulting in significant morbidity and even mortality of the mother and the child. Pritchard regimen is well established anticonvulsant protocol with good result in the management of eclampsia. To reduce the MgSO4 toxicity in low weight Indian women, a low dose regimen is tried. The low dose protocol is--a loading dose of 4 gm of MgSO4 slow IV; followed by a maintenance dose of 2 gms of MgSO4 slow IV every three hours; continued for 24 hours after delivery or 24 hours after last convulsion, whichever is later; If a convulsion occurs during treatment, an additional dose of 2 gms of MgSO4 is given slow IV in addition to the regular dose.

During calendar years 2017, 2018,123 women were treated for eclampsia. 69 women got admitted for eclampsia, 15 had eclampsia after admission, 39 women were referred from other hospitals for management. 60% had antenatal or antepartum eclampsia. One third had postpartum eclampsia, the remaining being intrapartum cases. 40% of women had BP less than 160/110 and 60% above 160/110 mm of Hg. Of the 81 direct admissions-- two thirds had eclampsia at or after 37 weeks; 60% had vaginal delivery unaided; 1/6 had instrumental vaginal delivery; and in 1/4th of women, the termination was done by LSCS. Of these 81 women, 13 were admitted with absent FH; 5 had intrapartum fetal death;  of the 63 live births, 90% fair Apgar score; 10% with poor Apgar score at 5 minutes of delivery; there were 3 early neonatal deaths. One woman had eclampsia with 10 fits, went into coma and died. Others are well at discharge. Low dose MgSO4 regimen is equally efficacious as Pritchard`s regimen. Maternal and fetal morbidity and mortality were almost same in the low dose regimen when compared with Pritchard regimen.

Keywords: Eclampsia, Magnesium Sulfate, Pritchard regimen, Low dose regimen, Maternal and Fetal Morbidity and Mortality.