MAGNESIUM SULPHATE THERAPY IN ECLAMPSIA: A 5 YEARS EXPERIENCE AT A TEACHING HOSPITAL

Objective: To describe the presentation of eclampsia, its management and associated outcomes using magnesium sulphate (MgSO4), over a five years period at a tertiary care hospital. Methodology: This descriptive study was conducted at Obstetrics and Gynecology unit, Hayatabad Medical Complex, Peshawar from January 2004 to December 2008. Data was collected from all patients presenting with eclampsia. Results: A total of 146 patients had eclampsia. Unbooked were 124 (84.93%). Mean age 23 years ± 5.3 years (range 18-38 years), primigravida were 69.17 %(101 cases). Antepartum fits in 72.6 % (106 cases), intrapartum 14 (9.58%) and 27(18.49%) postpartum. MgSO4 was used in all except 4 with oliguria, they were given diazepam. Recurrent fit occurred in only 20(13.69%). MgSO4 toxicity occurred as respiratory depression in 9 cases., depressed tendon reflexes in 10 and decreased urine output in 13 cases Total deliveries were 23021, prevalence of eclampsia was 0.63% .Mode of delivery was Vaginal in 97 (66.43%), instrumental in 29 (19.98%) and cesarean section in 20 (13.69%)cases. There were 26(17.2%) stillbirths and 4 neonatal deaths. Complications included HELLP in 17 (11.64%), pulmonary complications in 17, renal failure in 7(4.79%), DIC in 16(10.95%) and temporary blindness in 16 cases. Eleven (7.53%) maternal deaths occurred, causes included DIC in 1case, HELLP in 2, renal failure 1, cardiopulmonary failure in 2 and CVA (recieved deeply unconscious) in 5 cases. All were unbooked cases and with delay in reaching hospital. Conclusion: Eclampsia is common antenatally and in primigravidae, and a major cause of maternal morbidity and mortality in our region.It was effectively controlled with MgSO4, preventing recurrent fits and safe for both mother and fetus.