Maternal outcomes of magnesium sulphate and diazepam use in women with severe pre-eclampsia and eclampsia in Ethiopia

  • Gizat Molla Kassie
  • Dereje Negussie
  • Jemal Hussien Ahmed
Keywords: Magnesium Sulfate, Diazepam, Hypertension, Pregnancy-Induced, Seizures, Pregnant Women, Comparative Effectiveness Research, Ethiopia

Abstract

Background: Preferred anticonvulsant used to treat and prevent fits in eclampsia currently is magnesium sulphate. Clinical monitoring of tendon reflexes, respiration rate and measuring hourly urine output should be done to ensures safe administration of magnesium sulphate

Objective: This study was conducted to evaluate maternal outcomes of magnesium sulphate and diazepam use in the management of severe pre-eclampsia and eclampsia in Jimma University Specialized Hospital.

Methods: A retrospective hospital based cross-sectional comparative study was conducted using data collection format. Data was collected from the hospital delivery care register and patient chart records of all pregnant women who presented with the diagnosis of severe pre-eclampsia and eclampsia in two years and three months period from January, 2010 to April, 2012. Data analysis was done by SPSS version 16.0. A P-value of <0.05 was considered statistically significant in all tests.

Results: A total of 357 patient charts, 217 from magnesium sulphate and 140 from diazepam treated pregnant women group, were reviewed and analyzed. Three pregnant women from the magnesium sulphate treated group and eleven pregnant women from diazepam treated group had at least one convulsion after taking the drug. Greater proportion of patients in the magnesium sulphate treated group had less than four days postpartum stay as compared to the diazepam treated patients (82.3% versus 66.2%). Seizure occurrence, duration of postpartum hospital stays and birth outcome had a statistically significant association with the type of anticonvulsant used.

Conclusions: Magnesium sulphate is more effective than diazepam in the management of severe pre-eclamptic and eclamptic pregnant women in terms of seizure prevention, shortening postpartum hospital stay and reducing maternal morbidities.

Downloads

Download data is not yet available.

Author Biography

Gizat Molla Kassie
Department of pharmacy

References

1. Mizutani S, Wright J, Kobayashi H. A new approach regarding the treatment of preeclampsia and preterm labor. Life Sci. 2011;88(1-2):17-23. doi: 10.1016/j.lfs.2010.10.013

2. Mundle S, Regi A, Easterling T, Bivas Biswas B, Bracken H, Khedekar V, Shekhavat DR, Durocher J, Winikoff B. Treatment approaches for preeclampsia in low-resource settings: A randomized trial of the Springfusor pump for delivery of magnesium sulfate. Pregnancy Hyperten. 2012;2(1):32-38. doi:10.1016/j.preghy.2011.09.002

3. Gracia VD. Maternal deaths due to eclampsia and HELLP syndrome. Int J Gynaecol Obstet. 2009;104(2):90-94. doi: 10.1016/j.ijgo.2008.09.014

4. Duley L, Gulmezoglu A. Magnesium sulphate versus lytic cocktail for eclampsia. Cochrane Database Syst Rev. 2001;(1):CD002960.

5. Drug Aministration and Control Authority E. Standard treatment guidelines for zonal hospitals. Obstetrics and gynecological conditions. Addis Ababa 2010. p. 265-266.

6. Ministry of Health FDRE. Management Protocol on Selected Obstetrics Topics. Addis Ababa 2010. p. 181-182.

7. Muganyizi P, Shagdara M. Predictors of extra care among magnesium sulphate treated eclamptic patients at Muhimbili National Hospital, Tanzania. BMC Pregnancy Childbirth. 2011;11:41. doi: 10.1186/1471-2393-11-41

8. Altman D, Carroli G, Duley L, Farrell B, Moodley J, Neilson J, Smith D; Magpie Trial Collaboration Group. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo controlled trial. Lancet. 2002;359(9321):1877-1890.

9. Tukur J, Muhammad Z. Management of eclampsia at AKTH: before and after magnesium sulphate. Niger J Med. 2010;19(1):104-107.

10. ESOG. Magnesium Sulphate use for prevention of Preeclampsia and Eclampsia related mortality in Ethiopia 2011; Available from: http://www.esog.org.et/Projects.htm (accessed 2012 February 3).

11. Office JUER. Jimma University Specialized Hospital and Existing medical services 2012. Available from: http://www.ju.edu.et/jimma-university-specialized-hospital-jush (accessed 2012 February 3).

12. Wolde Z, Segni H, Woldie M. hypertensive disorders of pregnancy in Jimma University Specialized Hospital. Ethiop J Health Sci. 2011;21(3):147-154.

13. Which anticonvulsant for women with eclampsia? Evidence from the collaborative eclampsia trial. Lancet. 1995;345(8963):1455-63.

14. Chaudhary P. Eclampsia: before and after magnesium sulphate. JNMA J Nepal Med Assoc. 2005;44(160):124-128.

15. Tannirandorn Y. Is magnesium sulfate for prevention or only therapeutic in preeclampsia. J Med Assoc Thai. 2005 Jul;88(7):1003-1010.

16. Duley L, Gulmezoglu AM, Henderson-Smart DJ, Chou D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev. 2010;(11):CD000025. doi: 10.1002/14651858.CD000025.pub2

17. Getaneh W, Kumbi S. Use of magnesium sulfate in pre-eclampsia and eclampsia in teaching hospitals in Addis Ababa: a practice audit. Ethiop Med J. 2010;48(2):157-164.

18. Ikramullah K, Ambreen, Humera. Magnesium Sulfate Versus Diazepam Infusion in Eclampsia. Annals of King Edward Medical University. 2009;15(3):149-151. Available at http://www.annalskemu.org/journal/index.php/annals/article/viewArticle/84

19. Ola RE, Odeneye O, Abudu OO. Eclampsia: A Randomized Double Blind Trial of Magnesium Sulphate and Diazepam in Lagos, Nigeria. Trop J Obstet Gynaecol. 2005; 21(2):143-147.

20. Duley L, Henderson-Smart DJ, Walker GJ, Chou D. Magnesium sulphate versus diazepam for eclampsia (Review). Cochrane Database Syst Rev. 2010;(12):CD000127. doi: 10.1002/14651858.CD000127.pub2

21. Sharma R, Sharma V. Effect of magnesium sulphate versus phenytoin on the hospital length of stay of patients of eclampsia and severe preeclampsia. Journal of Chemical and Pharmaceutical Research 2012;4(4):1921-1924. Available at http://jocpr.com/vol4-iss4-2012/JCPR-2012-4-4-1921-1924.pdf

22. MCHIP. Report of second technical working group meeting on pre-eclampsia/eclampsia. Washington, DC.2009.

23. Coalition RHs. Product Brief Caucus on New and Underused Reproductive Health Technologies 2012.

24. Engender Health. A Report on Barriers and Solutions to Treat Pre-eclampsia & Eclampsia 2007

25. Ugwu EO, Dim CC, Okonkwo CD, Nwankwo TO. Maternal and perinatal outcome of severe pre-eclampsia in Enugu Nigeria after introduction of Magnesium sulfate. Niger J Clin Pract. 2011;14(4):418-421. doi: 10.4103/1119-3077.91747
Published
2014-06-26
How to Cite
1.
Kassie GM, Negussie D, Ahmed JH. Maternal outcomes of magnesium sulphate and diazepam use in women with severe pre-eclampsia and eclampsia in Ethiopia. Pharm Pract (Granada) [Internet]. 2014Jun.26 [cited 2019Aug.19];12(2):400. Available from: https://pharmacypractice.org/journal/index.php/pp/article/view/400
Section
Original Research