Efficacy of a Single-Loading Dose of Magnesium Sulphate in Preventing Convulsions in Women With Eclampsia: A Quasi-experimental Study

TL;DR

A single dose of magnesium sulphate effectively prevents seizures in women with eclampsia, offering a simpler treatment option in low-resource areas.

Contribution

This study demonstrates the efficacy of a single-loading dose of magnesium sulphate in preventing recurrent convulsions in eclampsia.

Findings

A single-loading dose of magnesium sulphate was effective in 80.5% of women with eclampsia.

Booking status and monthly income were significantly associated with treatment outcomes.

The regimen is suitable for resource-limited settings due to its simplicity and high efficacy.

Abstract

Eclampsia remains a major contributor to maternal morbidity and mortality in low-resource settings. Magnesium sulphate is the anticonvulsant of choice; however, prolonged maintenance regimens can be challenging to implement. This study aimed to evaluate the efficacy of a single-loading dose of magnesium sulphate in preventing recurrent convulsions among women presenting with eclampsia. This analytical quasi-experimental study was conducted in the Obstetrics and Gynecology units of Civil Hospital, Karachi, from September 8, 2021, to March 7, 2022. A total of 113 women aged 18-40 years, with singleton pregnancies between 37 and 41 weeks of gestation and diagnosed with eclampsia, were enrolled through non-probability consecutive sampling. Each participant received a single IV dose of magnesium sulphate (4 g IV over 8-10 minutes followed by 4 g intramuscular (IM)). No maintenance dose was given. Efficacy, defined as the absence of recurrent convulsions within 24 hours, was recorded. Data were analyzed using SPSS version 26.0, with chi-square tests applied to assess associations (p ≤ 0.05 considered significant). The mean age of participants was 28.93 ± 4.46 years, and the mean gestational age was 38.31 ± 1.20 weeks. Most women were multiparous (87.6% with parity 0-2), booked (54.0%), and from rural areas (61.1%). Overall, efficacy was observed in 91 women (80.5%). Most variables, including age, gestational age, parity, BMI, history of eclampsia, place of residence, and education level, were not significantly associated with efficacy (p > 0.05). However, booking status (unbooked: 88.3% vs. booked: 79.2%; p = 0.018) and monthly income (<20,000 Pakistani rupee (PKR): 84.8% vs. >40,000 PKR: 87.5%; p = 0.041) showed statistically significant associations with treatment outcomes. A single-loading dose of magnesium sulphate was effective in preventing recurrent convulsions in the majority of women with eclampsia. Given its simplicity and high efficacy, this regimen may be particularly useful in resource-limited settings where maintenance therapy is difficult to administer. Larger multicenter studies are recommended to validate these findings and assess long-term outcomes.