The efficacy of intramuscular loading dose of MgSO4 in severe pre-eclampsia/ eclampsia at a tertiary referral centre in Northwest Nigeria

Abstract

Aims and objectives: The efficacy of 10g intramuscular loading dose of magnesium sulphate in women with severe preeclampsia/eclampsia was assessed at a tertiary health centre for potential use at primary health level.

Subjects and methods: Intramuscular 10g loading dose and 14g loading dose of Pritchard were compared in women with severe preeclampsia/eclampsia. Primary outcome measures were the occurrence of fits in women with severe preeclampsia, further fits in those with eclampsia and maternal death. Other outcome measures were mode of delivery and severe birth asphyxia at 5 minutes of life.

Results: One hundred and three women were enrolled; 54 and 49 women had 10g and 14g loading dose respectively. No significant convulsions (p= 0.1424) occurred in women with severe preeclampsia who had 10g intramuscular loading dose and repeat convulsion was averted in 93% of women with eclampsia. 10g loading dose did not increase the likelihood of caesarean section in women with preeclampsia (p=0.2832) or eclampsia (p=0.9112). The mean Apgar score at 5 minutes of life of neonates whose mothers had 10g and 14g loading dose for preeclampsia was 8 and 8.46 respectively, and 8.9 and 8.8 respectively for eclampsia. There was no statistically significant difference in maternal death between the two groups for severe preeclampsia (p= 0.2020) and eclampsia (p=0.3496).

Conclusion: This study suggests a potential use of intramuscular 10 gram loading dose of MgSO4 at the primary health care level in Nigeria.