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Journal Article
Randomized Controlled Trial
A shortened postpartum magnesium sulfate prophylaxis regime in pre-eclamptic women at low risk of eclampsia.
OBJECTIVE: To determine whether magnesium sulfate (MgSO(4)) prophylaxis is needed for up to 24 hours postpartum in all patients with pre-eclampsia.
METHODS: In a randomized open clinical trial conducted in a tertiary health center in India between September 2008 and April 2010, 150 women with severe pre-eclampsia who received intrapartum MgSO(4) and delivered at more than 2 weeks gestation were enrolled. After 6hours postpartum, the participants were randomized to continue receiving (control group) or to discontinue (intervention group) MgSO(4), and outcomes were compared.
RESULTS: Administration of MgSO(4) had to be reinstituted for 1 woman in the intervention group. Under the current protocol in the institution, all 75 women in the intervention group would have received MgSO(4) for 24 hours postpartum. A significant reduction in time spent by the doctors (P<0.001) and nurses (P<0.001) was seen in the intervention group. The pain score in the intervention group was significantly less (P<0.001), and women in the intervention group were able to look after themselves better (P<0.001).
CONCLUSION: For women at low risk for postpartum eclampsia, a shortened (6-hour) MgSO(4) regime was as effective for seizure prophylaxis as the conventional 24-hour regime, with significant benefits in terms of cost and morbidity.
METHODS: In a randomized open clinical trial conducted in a tertiary health center in India between September 2008 and April 2010, 150 women with severe pre-eclampsia who received intrapartum MgSO(4) and delivered at more than 2 weeks gestation were enrolled. After 6hours postpartum, the participants were randomized to continue receiving (control group) or to discontinue (intervention group) MgSO(4), and outcomes were compared.
RESULTS: Administration of MgSO(4) had to be reinstituted for 1 woman in the intervention group. Under the current protocol in the institution, all 75 women in the intervention group would have received MgSO(4) for 24 hours postpartum. A significant reduction in time spent by the doctors (P<0.001) and nurses (P<0.001) was seen in the intervention group. The pain score in the intervention group was significantly less (P<0.001), and women in the intervention group were able to look after themselves better (P<0.001).
CONCLUSION: For women at low risk for postpartum eclampsia, a shortened (6-hour) MgSO(4) regime was as effective for seizure prophylaxis as the conventional 24-hour regime, with significant benefits in terms of cost and morbidity.
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