Management of eclampsia at AKTH: before and after magnesium sulphate

Abstract

Background: Eclampsia contributes significantly to maternal and perinatal morbidity and mortality in Nigeria. The world Health Organisation recommended Magnesium Sulphate as the most effective, safe and low cost drug for the treatment of eclamptic seizures and for prophylaxis in severe pre-eclamptic. This study is aimed to evaluate the effect of the introduction of magnesium sulphate for the management of eclamptic seizures on maternal and fetal indices in Aminu Kano Teaching Hospital [AKTH], Kano.

Methods: A retrospective study of all patients who presented with eclampsia in AKTH, Kano. The study period included 3 years prior to introduction of magnesium sulphate [January 2002 - December 2004] and 3 years after its introduction [January 2005 - December 2007].

Results: During the study period, the prevalence of eclampsia was 1.02% [1:97 deliveries]. Sixty six [50.5%] of the patients were aged 19 and below. Approximately 62% of the patients were primigravida and 87% were unbooked. Thirty eight [29%] were treated with diazepam while ninety three [71%] were treated with magnesium sulphate. 39.4% of those treated with diazepam died compared to 15% of those treated with magnesium sulphate. Approximately ninety percent of those that died had no antenatal care. Overall perinatal mortality rate in this study was 312 per 1000 births. 368.4 per 1000 births among those treated with diazepam and 296.7 per 1000 births in the magnesium sulphate group. Approximately nine percent of those treated with magnesium sulphate develop toxicity [85.5% renal and 12% respiratory].

Conclusion: This study is in support of the findings that magnesium sulphate is superior to diazepam in the reduction of maternal morbidity and mortality.