Is Zuspan Regimen Adequate for Preventing Eclampsia?: A Case Report
DOI:
https://doi.org/10.15850/amj.v5n4.1357Keywords:
Mg SO4, eclampsia, Zuspan, PritchardAbstract
Magnesium sulphate (MgSO4) is believed to treat preeclampsia and eclampsia for more than a century with a total dose of MgSO4 varying from 2 to 5g per 24 hours. Zuspan and Pritchard are two internationally recommended regimens that are accepted as the standard regimen.
In this case report, we presented a 41 year old woman with puerperal preeclampsia prescribed with a complete Zuspan regimen. She had eclamptic seizure after completing Zuspan regimen with Mg SO4 level of 4.3 mg/dL.
In this case, the possibility of eclamptic seizures might be due to a lack of MgSO4 dose. The administration of MgSO4 for preeclampsia with severe features and prophylactic of eclampsia should be adjusted.
References
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A-B, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.
Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P, Canadian Hypertensive Disorders of Pregnancy Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Can JOGC J Obstet Gynecol Can JOGC. 2014;36(5):416–41.
National Institute for Health and Care Excellence (NICE). Hypertension in Pregnancy. Clinical guideline [CG107]. London: NICE; 2010.
Hypertension in Pregnancy: Executive Summary. Obstet Gynecol. 2013;122(5):1122.
Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33(3):130–7.
WHO. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia [Internet]. WHO. [cited 2018 Aug 27]. Available from: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/9789241548335/en/
Duley L, Gülmezoglu AM, Henderson-Smart DJ, Chou D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev. 2010;(11):CD000025.
Pratt JJ, Niedle PS, Vogel JP, Oladapo OT, Bohren M, Tunçalp Ö, et al. Alternative regimens of magnesium sulfate for treatment of preeclampsia and eclampsia: a systematic review of non-randomized studies. Acta Obstet Gynecol Scand. 2016;95(2):144–56.
Magpie Trial Follow-Up Study Collaborative Group. The Magpie Trial: a randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for women at 2 years. BJOG Int J Obstet Gynaecol. 2007;114(3):300–9.
Sibai BM, Graham JM, McCubbin JH. A comparison of intravenous and intramuscular magnesium sulfate regimens in preeclampsia. Am J Obstet Gynecol. 1984;150(6):728–33.
Euser AG, Cipolla MJ. Magnesium sulfate treatment for the prevention of eclampsia: A brief review. Stroke J Cereb Circ. 2009;40(4):1169–75.
Salinger DH, Mundle S, Regi A, Bracken H, Winikoff B, Vicini P, et al. Magnesium sulphate for prevention of eclampsia: are intramuscular and intravenous regimens equivalent? A population pharmacokinetic study. BJOG Int J Obstet Gynaecol. 2013;120(7):894–900.
Okusanya BO, Oladapo OT, Long Q, Lumbiganon P, Carroli G, Qureshi Z, et al. Clinical pharmacokinetic properties of magnesium sulphate in women with pre-eclampsia and eclampsia. BJOG Int J Obstet Gynaecol. 2016;123(3):356–66.
The Eclampsia Trial Collaborative Group. Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial. The Lancet. 1995;345(8963):1455–63.
Gordon R, Magee LA, Payne B, Firoz T, Sawchuck D, Tu D, et al. Magnesium sulphate for the management of preeclampsia and eclampsia in low and middle income countries: a systematic review of tested dosing regimens. J Obstet Gynaecol Can. 2014;36(2):154–63.
Dayicioglu V, Sahinoglu Z, Kol E, Kucukbas M. The use of standard dose of magnesium sulphate in prophylaxis of eclamptic seizures: do body mass index alterations have any effect on success? Hypertens Pregnancy. 2003;22(3):257–65.
Anderson JK, Boyd CI. Effect of Maternal Body Mass Index on Serum Magnesium Levels Given for Seizure Prophylaxis. Obstet Gynecol. 2013;122(2 PART 1):394.
Downloads
Published
Issue
Section
License
- Authors retain copyright and grant Althea Medical Journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to freely share and remix the work with an acknowledgement of the work's authorship and initial publication in Althea Medical Journal. Althea Medical Journal is licensed under CC BY-NC 4.0
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Althea Medical Journal.
