A DOUBLE BLIND RANDOMIZED CLINICAL TRIAL COMPARING PRITCHARD S REGIMEN WITH LOW DOSE REGIMEN IN WOMEN WITH SEVERE PRE ECLAMPSIA AND ECLAMPSIA

CORRESPONDING AUTHOR:
Dr. Miriam George Fenn,
Associate Professor,
Department of Obstetrics and Gynaecology,
MOSC Medical College,
Kolenchery-682311, Kerala.
Email: kirthanajacob@hotmail.com

ABSTRACT: OBJECTIVES: To compare Pritchard’s regimen of magnesium sulphate with a low dose magnesium sulphate regimen in women with severe pre eclampsia and eclampsia. AIMS: 1.To determine if clinical signs and symptoms of magnesium toxicity are less in women with low dose as compared to Pritchard’s regimen. 2. To determine if low dose magsulf will suffice in preventing onset of convulsions in severe pre eclampsia and recurrence of convulsions in patients with eclampsia. MATERIALS AND METHODS: SETTING: tertiary level teaching hospital in Tamilnadu, India. PARTICIPANTS: all women with eclampsia 1. All women with severe pre eclampsia meeting any of the following criteria: a) diastolic BP> 110 and proteinuria 2+ or more b) diastolic BP< 110 but 3+ proteinuria c) pre eclampsia with symptoms of impending eclampsia – headache, blurring of vision, epigastric pain. RESULTS: Primary outcome of side effects was not different in Pritchard’s and low dose regimen. Secondary outcome of efficacy of low dose where low dose regimen was found to be equally efficacious to Pritchard’s regimen in preventing recurrence of convulsions in eclampsia. CONCLUSIONS: 1. Magnesium sulphate is an effective and safe anti convulsant with very infrequent serious toxicity. Side effects with low dose regimen were not significantly less than those with Pritchard’s regimen. 2. Low dose of magnesium sulphate can effectively prevent onset or recurrence of convulsions in women with severe pre eclampsia and eclampsia. 3. Implications for future research would be to test the minimum effective dose of magsulf and if only the loading dose is enough.

KEYWORDS: Magnesium sulphate, eclampsia.