EXPECTANT MANAGEMENT IN SEVERE PREECLAMPSIA - DOES MAGNESIUM-SULFATE PREVENT THE DEVELOPMENT OF ECLAMPSIA

Although magnesium sulfate has been a traditional or standard treatmen t for severe preeclampsia and eclampsia to prevent convulsions, its ef ficiency has always been in doubt and its induced side-effects also ma ke it controversial for use. In this study, 64 patients, diagnosed wit h severe preeclampsia, were randomized into group I (34 patients) mana ged with MgSO4, and group II (30 patients) managed without MgSO4. Ther e were no occurrences of eclampsia in either group. Although there was no statistical significance in the final delivery method, group I had a higher rate in cesarean section, in which most were significantly d ue to fetal distress (p<0.05). Furthermore, group I had significantly more babies with poor apgar score than group II (p=0.019). During the reatment period for those with a gestational age of less than 34 weeks , there were two patients with abruptio placentae in group I and the t reatment periods were noted to be longer in group II than in group I. From the results of monitoring serum magnesium level in group I, when therapeutic level was achieved, magnesium sulfate induced great discom fort which might have led to the deterioration of the patients' condit ion. According to this study, magnesium sulfate's minimal efficiency, and its adverse side-effects, also make magnesium sulfate a poor choic e in the management of preeclampsia. Therefore, because of our poor un derstanding of the etiology of preeclampsia, suitable management shoul d be undertaken without magnesium sulfate. Improvement of the patient' s pathophysiological condition or termination of pregnancy as early as possible, is recommended.