Intravenous versus Intramuscular Magnesium Sulfate for the Management of Severe Preeclampsia and Eclampsia

Introduction: Eclampsia and preeclampsia are two of the leading causes of maternal mortality. If not treated promptly and effectively, eclamptic convulsions can be fatal emergencies with a significant risk of morbidity and death. One of the most important eclampsia management principles is controlling convulsions. When treating eclampsia, magnesium sulfate is the gold standard for anticonvulsant activity. This study was designed to assess the efficacy of intravenous versus intramuscular magnesium sulfate in severe preeclampsia and eclampsia cases. Materials and Methods: A total of 116 pregnant women with eclampsia, imminent eclampsia, or severe preeclampsia were randomly allocated to two groups and managed with Pritchard regimen (Group 1) and Zuspan regimen (Group 2). Serum magnesium levels, maternal complications, neonatal outcome and status of seizure recurrence was reported. Results: The most prevalent mode of delivery was LSCS in 58.62% of group 1 and 62.06% of group 2. The APGAR scores were 6.44 and 6.70 at 1 minute, and 8.08 and 8.39 after 5 minutes. The average birth weight was 2.47 kg in group 1 and 2.30 kg in group 2. Seizure recurrence was observed in 5.17% of cases in group 1 and 1.72% in group 2. Abruption (8.65%) and HELLP (8.62%) were the most prevalent maternal complications in group 2. Conclusion: The magnesium sulfate regimens administered intramuscularly and intravenously are equally beneficial in reducing the negative effects experienced by both the mother and the foetus. In contrast to intravascular infusion of magnesium sulfate, which carries a lower risk of toxicity, intramuscular magnesium sulfate is unpleasant and has a poorer compliance rate.