Pharmacotherapy Practices and Clinical Outcomes of Pre-Eclampsia/Eclampsia: An Observational study

Abstract

Background: This study observes fetal, pregnancy, and maternal outcomes with different regimens of Magnesium sulphate (MgSO4), used for prophylaxis and treatment of convulsions in eclampsia.
Methods: In this observational study, the current prescribing practice and management outcomes of pre-eclampsia/eclampsia were observed in three tertiary care hospitals in Lahore, Pakistan. Data were collected by using data collection form, containing information related to patient demographics, history, laboratory findings, drug administration record, and therapeutic outcomes for pregnancy, fetus, and mother.
Results: Of the 50 patients studied, most (74%) were of eclampsia. The mean age of the patients was 25.7 (+5.05) years with the majority (36%) in the age range 21–25 years. Forty-one patients received MgSO4, of which most received the Pritchard regimen (n = 35), whereas only 5 patients were managed with Zuspan regimen. Liner logistic analysis revealed better fetal outcomes (OR 0.217, CI –0.283 – 1.543) and pregnancy outcomes (OR 0.186, CI –0.164 – 0.635) with Zuspan regimen as compared to Pritchard. Whereas, both regimens showed no difference in maternal outcomes (OR 0.044, CI –0.129 – 0.170).
Conclusion: Zuspan regimen proved to be better in morbidity and mortality associated with eclampsia. Additionally, national as well as institutional guidelines should be developed, implemented, properly monitored, and evaluated for management of preeclampsia/ eclampsia. Mandatory in-service training and expertise should be provided for health professionals at all levels of the healthcare system, especially those working in gynecological setup.