Shorter course of Magnesium Sulphate helps prevent Eclamptic seizures

In a recent study it was found that the use of postpartum magnesium sulphate for a shorter period of time did not raise the likelihood of eclamptic seizures; nonetheless, the evidence is insufficient to draw solid conclusions. The findings of this study were published in Obstetrics and Gynecology on 10th March, 2022.

Preeclampsia affects 2–8% of all pregnancies worldwide and is associated with considerable maternal and neonatal problems. Maureen Okonkwo and colleagues did this study with the goal of estimating the appropriate period of postpartum magnesium sulphate to avoid eclampsia.

From their establishment until January 2020, the databases EMBASE, MEDLINE, CINAHL, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov were searched for English-language human randomized controlled trials. The key words "eclampsia," "magnesium sulphate," and "postpartum" were included in the search strategy. Covidence data-management software was used for the review. The final evaluation contained 10 studies from the 3,629 publications that were reviewed. Studies that examined two separate time points of magnesium sulphate postpartum in women with either eclampsia or preeclampsia were considered.

The key findings of this study were as follow;

1. Two writers independently reviewed the studies.

2. The RevMan programme was used to compute risk difference (RD) and mean difference (MD) for categorical outcomes and mean difference (MD) for continuous outcomes.

3. When compared to 24-hour postpartum regimens, shorter durations of magnesium sulphate (12 hours or less) were not related with an increased risk of eclampsia.

4. Shorter regimens did not enhance the risk of eclampsia in studies including preeclampsia or eclampsia.

5. Secondary outcomes such as flushing, Foley catheter insertion time, time to ambulation, and hospital stay were all reduced with shorter-duration magnesium sulphate.

In conclusion, this comprehensive review and meta-analysis discovered that shorter-duration postpartum magnesium sulphate did not raise the incidence of eclampsia, despite data showing high heterogeneity and being insufficient to draw definite conclusions. To identify the best duration of magnesium sulphate in women with preeclampsia or eclampsia, a well-designed, worldwide, sufficiently powered clinical research is still required.

Reference:

Okonkwo, M., & Nash, C. M. (2022). Duration of Postpartum Magnesium Sulphate for the Prevention of Eclampsia. In Obstetrics & Gynecology: Vol. Publish Ahead of Print. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/aog.0000000000004720

Keywords: Postpartum, delivery, eclampsia, magnesium sulphate, pregnancy,  seizure, flushing, ambulation, maternal, Obstetrics and Gynecology,