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 usingmagnesium 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