Abbreviated (12-hour) versus traditional (24-hour) postpartum magnesium sulfate therapy in severe pre-eclampsia

Abstract

Objective: To compare the use of magnesium sulfate for 12 hours versus 24 hours in postpartum women with stable severe pre-eclampsia.

Methods: In 2011, an open randomized clinical trial was conducted with 120 postpartum women with severe pre-eclampsia who gave birth at a tertiary hospital in Brazil; 60 women received magnesium sulfate for 24 hours and 60 for 12 hours. The analysis was by intention-to-treat and the intervention was not masked.

Results: Abbreviated (12-hour) magnesium sulfate therapy was associated with less exposure to the drug, and clinical outcomes were similar in both groups. No woman developed eclampsia and there was no need to re-initiate treatment after completing the scheduled magnesium sulfate therapy in either group. Magnesium sulfate therapy was extended in only three women in the 12-hour group. In addition, in this group, significant reductions were found in the duration of postpartum use of an indwelling bladder catheter, the time to ambulation, and the time to maternal contact with the newborn.

Conclusion: Abbreviated postpartum magnesium sulfate therapy in patients with stable severe pre-eclampsia was associated with less drug exposure, similar outcomes, and benefits such as a reduction in the time to contact with the newborn.

Clinical trials registration: clinicaltrials.gov NCT1408979.

Trial registration: ClinicalTrials.gov NCT01408979.

Keywords: Magnesium sulfate therapy; Postpartum; Pre-eclampsia.