Abbreviated 12-Hour Postpartum Magnesium Sulphate Therapy is Equally Effective and Safer Than Standard 24-Hour Therapy in Preeclampsia With Severe Features: Results From A Randomized Controlled Trial

Objective: Eclampsia is a major life-threatening complication of preeclampsia with severe features leading to significant perinatal and maternal mortality and morbidity. Magnesium sulphate (MgSO4) is the first-line therapy for eclampsia prevention and treatment, however, its use is associated with...

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Main Authors: Pradip Kumar Saha, Seema Sheokand, L K Dhaliwal, Rashmi Bagga, Lekha Saha
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2025-04-01
Series:Journal of Family and Reproductive Health
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Online Access:https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3050
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author Pradip Kumar Saha
Seema Sheokand
L K Dhaliwal
Rashmi Bagga
Lekha Saha
author_facet Pradip Kumar Saha
Seema Sheokand
L K Dhaliwal
Rashmi Bagga
Lekha Saha
author_sort Pradip Kumar Saha
collection DOAJ
description Objective: Eclampsia is a major life-threatening complication of preeclampsia with severe features leading to significant perinatal and maternal mortality and morbidity. Magnesium sulphate (MgSO4) is the first-line therapy for eclampsia prevention and treatment, however, its use is associated with serious adverse effects and there is no consensus on the optimal duration of its therapy. This study compares the efficacy and safety of abbreviated 12-hour versus standard 24-hour MgSO4 therapy during postpartum in patients having preeclampsia with severe features. Materials and methods: Patients having preeclampsia with severe features were randomized 1:1 into the 12-hour and 24-hour groups. Modified Pritchard regimen was used. The primary outcome was the incidence of seizures. Secondary outcomes included serious maternal morbidity and other adverse effects associated with MgSO4 use. Perinatal outcomes were also recorded. Analyses were intention-to-treat. Results: A total of 116 patients [57 (12-hour group) and 59 (24-hour group)] were included. The mean age was 25(±4) years, while the mean gestation period was 34 (±4) weeks. The incidence of seizures was comparable in the two groups [1 (2%), 3 (5%), p=0.62]. Patients in the 12-hour group [1 (2%)] had lesser postpartum drowsiness compared to the 24-hour group [15 (25%), p<0.001] and consequently, lesser problems in breastfeeding [1 (2%) versus 10 (17%), p=0.008]. There were no inter-group differences in other adverse effects including loss of reflexes, oliguria, respiratory depression, and proportion of patients requiring interruption of therapy. Perinatal outcomes were also similar. Conclusion: In patients having preeclampsia with severe features, 12-hour postpartum MgSO4 therapy is equally effective in preventing eclampsia and has lesser postpartum drowsiness and problems with breast feeding compared to the standard 24-hour therapy.
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spelling doaj-art-fb10d76cf0524b33bb910a12209a406b2025-08-20T01:49:08ZengTehran University of Medical SciencesJournal of Family and Reproductive Health1735-89491735-93922025-04-0119110.18502/jfrh.v19i1.18437Abbreviated 12-Hour Postpartum Magnesium Sulphate Therapy is Equally Effective and Safer Than Standard 24-Hour Therapy in Preeclampsia With Severe Features: Results From A Randomized Controlled TrialPradip Kumar Saha0Seema Sheokand1L K Dhaliwal2Rashmi Bagga3Lekha Saha4Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Objective: Eclampsia is a major life-threatening complication of preeclampsia with severe features leading to significant perinatal and maternal mortality and morbidity. Magnesium sulphate (MgSO4) is the first-line therapy for eclampsia prevention and treatment, however, its use is associated with serious adverse effects and there is no consensus on the optimal duration of its therapy. This study compares the efficacy and safety of abbreviated 12-hour versus standard 24-hour MgSO4 therapy during postpartum in patients having preeclampsia with severe features. Materials and methods: Patients having preeclampsia with severe features were randomized 1:1 into the 12-hour and 24-hour groups. Modified Pritchard regimen was used. The primary outcome was the incidence of seizures. Secondary outcomes included serious maternal morbidity and other adverse effects associated with MgSO4 use. Perinatal outcomes were also recorded. Analyses were intention-to-treat. Results: A total of 116 patients [57 (12-hour group) and 59 (24-hour group)] were included. The mean age was 25(±4) years, while the mean gestation period was 34 (±4) weeks. The incidence of seizures was comparable in the two groups [1 (2%), 3 (5%), p=0.62]. Patients in the 12-hour group [1 (2%)] had lesser postpartum drowsiness compared to the 24-hour group [15 (25%), p<0.001] and consequently, lesser problems in breastfeeding [1 (2%) versus 10 (17%), p=0.008]. There were no inter-group differences in other adverse effects including loss of reflexes, oliguria, respiratory depression, and proportion of patients requiring interruption of therapy. Perinatal outcomes were also similar. Conclusion: In patients having preeclampsia with severe features, 12-hour postpartum MgSO4 therapy is equally effective in preventing eclampsia and has lesser postpartum drowsiness and problems with breast feeding compared to the standard 24-hour therapy. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3050EclampsiaMagnesium SulphatePre-Eclampsia
spellingShingle Pradip Kumar Saha
Seema Sheokand
L K Dhaliwal
Rashmi Bagga
Lekha Saha
Abbreviated 12-Hour Postpartum Magnesium Sulphate Therapy is Equally Effective and Safer Than Standard 24-Hour Therapy in Preeclampsia With Severe Features: Results From A Randomized Controlled Trial
Journal of Family and Reproductive Health
Eclampsia
Magnesium Sulphate
Pre-Eclampsia
title Abbreviated 12-Hour Postpartum Magnesium Sulphate Therapy is Equally Effective and Safer Than Standard 24-Hour Therapy in Preeclampsia With Severe Features: Results From A Randomized Controlled Trial
title_full Abbreviated 12-Hour Postpartum Magnesium Sulphate Therapy is Equally Effective and Safer Than Standard 24-Hour Therapy in Preeclampsia With Severe Features: Results From A Randomized Controlled Trial
title_fullStr Abbreviated 12-Hour Postpartum Magnesium Sulphate Therapy is Equally Effective and Safer Than Standard 24-Hour Therapy in Preeclampsia With Severe Features: Results From A Randomized Controlled Trial
title_full_unstemmed Abbreviated 12-Hour Postpartum Magnesium Sulphate Therapy is Equally Effective and Safer Than Standard 24-Hour Therapy in Preeclampsia With Severe Features: Results From A Randomized Controlled Trial
title_short Abbreviated 12-Hour Postpartum Magnesium Sulphate Therapy is Equally Effective and Safer Than Standard 24-Hour Therapy in Preeclampsia With Severe Features: Results From A Randomized Controlled Trial
title_sort abbreviated 12 hour postpartum magnesium sulphate therapy is equally effective and safer than standard 24 hour therapy in preeclampsia with severe features results from a randomized controlled trial
topic Eclampsia
Magnesium Sulphate
Pre-Eclampsia
url https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3050
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