ROLE OF MAGNESIUM-SULFATE IN SEIZURE PREVENTION IN PATIENTS WITH ECLAMPSIA AND PREECLAMPSIA

Eclampsia is a leading cause of maternal mortality. The prevention of seizure activity in pre-eclampsia and recurrent seizures in eclamptic patients is an essential aspect of management. Many drugs with anticon vulsant properties have been used to treat patients with pre-eclampsia and eclampsia. Magnesium sulfate is a significantly better drug than either diazepam or phenytoin for preventing recurrent seizures in ecla mptic patients. Magnesium sulfate has diverse cardiovascular and neuro logical effects and also alters calcium metabolism. Although the drug crosses the placenta and may affect the fetus, these effects are clini cally small and fetal morbidity has been shown to be reduced in random ised studies comparing magnesium sulfate to either phenytoin or benzod iazepines. Dosage regimens of magnesium sulfate are empirical. Because adverse effects of this agent are related to toxicity, the establishm ent of greater efficacy by using higher dosage regimens needs to be te sted against a greater risk of adverse effects. The most serious toxic ity related to magnesium sulfate use is neuromuscular blockade that ma y result in respiratory arrest. Magnesium sulfate is now the drug of c hoice for treating eclamptic patients. However, further studies are re quired to establish the role of this agent as a prophylactic agent in the prevention of eclampsia.