Magnesium sulfate and other anticonvulsants for women with pre-eclampsia
RHL practical aspects by Khan KS
FIRST CONTACT (PRIMARY CARE) LEVEL AND REFERRAL HOSPITAL (SECONDARY CARE) LEVEL
The incidence of eclampsia in developing countries is higher than in developed countries. Any programme for the prevention of eclampsia among women with pre-eclampsia requires consideration of education of all pregnant women about the importance of the need to seek prompt medical attention if any of the symptoms below representing severe pre-eclampsia occur:
- oedema of hands and face developing within a few days;
- a sudden increase in weight;
- persistent and severe headache;
- upper abdominal pain;
- blurred vision.
If the attending clinician chooses to use magnesium sulfate to prevent eclampsia in patients with severe pre-eclampsia, both the intramuscular (Pritchard) and intravenous (Zuspan) regimens could be used. In primary care settings it may be safer to use the intramuscular regimen.
Serum monitoring is not required although training in drug administration and monitoring are essential. Calcium gluconate (1 ampoule = 1 g) should be available as an antidote for magnesium sulfate toxicity whenever magnesium sulfate is used.
AT HOME OR IN THE COMMUNITY
Pregnant women should be informed about the danger signs of eclampsia even though the predictive value of the knowledge of these signs is relatively low.
This document should be cited as: Khan KS. Magnesium sulfate and other anticonvulsants for women with pre-eclampsia: RHL practical aspects (last revised: 8 September 2003). The WHO Reproductive Health Library; Geneva: World Health Organization.