Comparison of Short-Course Magnesium Sulfate and Standard Pritchard Regimen for Prevention of Recurrent Seizures in Eclampsia: A Prospective Comparative Study
Keywords:
Eclampsia, Magnesium sulfate, Short-course regimen, Pritchard regimen, Recurrent seizures, Maternal outcomes, Magnesium toxicity, ICU stay.Abstract
Background & Objectives: Eclampsia is a life-threatening obstetric emergency characterized by generalized tonic-clonic seizures in women with pre-eclampsia and remains a major cause of maternal morbidity and mortality. Magnesium sulfate is the standard anticonvulsant for preventing recurrent seizures; however, the conventional Pritchard regimen requires prolonged administration and close monitoring. This study compared the effectiveness and safety of a short-course magnesium sulfate regimen with the standard Pritchard regimen in women with eclampsia.
Methods: This prospective randomized interventional study was conducted in the Department of Obstetrics & Gynaecology, Pt. JNM Medical College and Dr. BRAM Hospital, Raipur, India, from August 2021 to December 2022. One hundred women with eclampsia were randomly allocated to receive either short-course magnesium sulfate (n=50) or the standard Pritchard regimen (n=50). The primary outcome was recurrent seizures, while secondary outcomes included magnesium toxicity, maternal complications, duration of ICU and hospital stay, and recovery parameters.
Results: No recurrent seizures occurred in either group (0% vs. 0%; p=0.943). Magnesium toxicity (0% vs. 12%; p=0.0352) and injection-site pain (10% vs. 92%; p<0.0001) were significantly lower with the short-course regimen. Maternal complications were comparable between groups (p>0.05). Women receiving the short-course regimen had shorter ICU and hospital stay, earlier breastfeeding and oral feeding, and lower healthcare resource utilization (all p<0.05).
Interpretation & Conclusions: Short-course magnesium sulfate is as effective as the standard Pritchard regimen in preventing recurrent seizures while reducing treatment-related toxicity, improving recovery, and decreasing healthcare resource utilization, making it a practical alternative for managing eclampsia, particularly in resource-limited settings.
