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Role of magnesium sulphate in hypertensive disorders of Pregnancy

Razia Mustafa Abbasi, Pushpa Sirichand..

Abstract
OBJECTIVE: To see the efficacy of Magnesium sulphate in preventing and controlling fits in hypertensive disorders of pregnancy. DESIGN: Descriptive Study. SETTING: Department of Gynaecology and Obstetrics, Liaquat University Hospital Hyderabad from January to December 2002. PATIENTS AND METHODS: Thirty one patients having severe hypertension (Systolic BP>160 and Diastolic>110mmHg) with or without proteinuria and fits were studied. Diagnosis was made through history, clinical findings and relevant investigations. Immediate management consisted of maintenance of intravenous line, clearance of airway and anti hypertensive medications for prevention and control of fits after excluding contraindications for magnesium sulphate therapy. All patients received Magnesium sulphate according to protocol. Occurrence and recurrence of fits, control of BP, side effects of magnesium sulphate, mode of delivery, maternal and fetal outcome were noted. RESULTS: Total 91 patients were diagnosed with blood pressure 140/100mmHg or above having severe pregnancy induced hypertension (PIH), pre-eclampsia and eclampsia during study duration. Out of these, 31 patients met criteria for magnesium sulphate therapy. Age range of patients was 16-35 years. Only 7 cases were booked and all eclamptic patients were referred cases. Majority of women was nullipara. Gestational age at admission was more than 35 weeks in 20 patients (64.51%). Twenty six women (83.87%) had blood pressure at admission > 160/110 mmHg. Fits were effectively controlled in eclamptic patients and none of the patients with pre-eclampsia and PIH developed fits who received magnesium sulphate. Fetal outcome was good in those who came at term with alive fetus and delivered by caesarean section. Nineteen (61.29%) fetus were alive, 8 were delivered still birth and 4 died during neonatal period. Only one patient had respiratory depression. There was no maternal death. CONCLUSION: Magnesium sulphate can be safely and effectively used for the prevention and control of fits in hypertensive disorders of pregnancy.

Key words: Magnesium Sulfate. Eclampsia. Anticonvulsants. Hypertension. Pre-Eclampsia. Tocolytic Agents. Phenytoin. Pregnancy Complications, Cardiovascular. Antihypertensive Agents.



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