The Value of Magnesium Sulfate in the Pre-Hospital Phase of theManagement of Eclampsia

Abstract

Eclampsia is a very serious complication of pregnancy, its occurrence is responsible of maternal and fetal morbidity and mortality. The aim of this study is to clarify the value of Magnesium Sulfate in the prevention of convulsive state and in the choice of anesthetic technique for cesarean section during eclampsia.
We realized a prospective descriptive, analytical and comparative study over a period of 5 months, concerning a series of 49 pregnant women admitted to the anesthesia-intensive care unit of the Souissi Maternity Hospital in Rabat, with eclampsia. The diagnosis of eclampsia was made due to the occurrence of convulsive seizure (s) linked to pregnancy-induced hypertension.
It was found that eclampsia mainly affected young women (age less than or equal to 25 years) with a percentage of 57.3%. The majority of patients were
first-time mothers (55.1%). This condition manifests itself most often in the last trimester of pregnancy (72.9%), especially in pre-partum. The majority of patients did not receive an antenatal consultation. The treatment of choice in our study was magnesium sulfate.
So, 51% of patients had not received magnesium sulfate before their admission to our hospital and 56% of them had had more than one seizure. And the 49% of patients, on the other hand, had received magnesium sulfate and only 18% of them had had the seizure again. Our obstetric attitude was based on immediate delivery with a caesarean section. 34.5% cesarean sections were performed under general anesthesia, compared with 65.5% under spinal anesthesia.
The fetus morbidity was mainly represented by prematurity (30.6%) and neonatal distress (28.5%). The prognosis of eclampsia remains bleak both for the mother with a maternal mortality rate of 4%, and for the fetus with a perinatal mortality rate of 16.3%.