Is Serum Magnesium Estimate Necessary in Patients with Eclampsia on Magnesium Sulphate?

• Published in: African journal of reproductive health 2005-04, Vol.9 (1), p.128-132
• Main Authors: Ekele, B. A., Badung, S. L. H.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anticonvulsants; Biological Availability; Blood; Cohort Studies; Developing Countries; Dosage; Dose-Response Relationship, Drug; Drug Administration Schedule; Eclampsia; Eclampsia - blood; Eclampsia - diagnosis; Eclampsia - drug therapy; Eclampsia, serum, magnesium, toxicity, anticonvulsant; Female; Follow-Up Studies; Humans; Infusions, Intravenous; Intravenous injections; Magnesium; Magnesium - blood; Magnesium Sulfate - therapeutic use; Maternal mortality rates; Medical treatment; Monitoring, Physiologic - methods; Nigeria; Preeclampsia; Pregnancy; Pregnancy Outcome; Risk Assessment; Severity of Illness Index; Sulfates
• ISSN: 1118-4841
• DOI: 10.2307/3583167

The therapeutic index of magnesium is said to be low, hence, there are fears of toxicity when used as anticonvulsant in eclamptic patients. The objective of this study was to determine the serum levels of magnesium in eclamptic patients treated with magnesium sulphate and relate the levels with clinical indicators. It was a prospective study involving consecutive eclamptic patients that were managed between January and December 2002, with magnesium sulphate as the sole anticonvulsant agent, using a modified Pritchard regimen. Blood samples were taken before the administration of the loading and maintenance doses of magnesium sulphate and serum levels of magnesium were estimated using the Jenway 605 colorimeter. There were 19 patients and 72 blood samples. The mean baseline serum magnesium was 0.72 ± 0.10mmol/L while serum magnesium levels when the patients were on treatment ranged from 1.95 to 2.82mmol/L. No serum magnesium level was greater than 3.0mmol/L and none of the patients had clinical evidence of magnesium toxicity. We conclude that serum magnesium levels in these patients were within the therapeutic range, therefore, routine estimation of this cation is not necessary. Even where the laboratory facility is available, it is suggested that serum estimation be limited to cases where clinical monitors suggest toxicity. (Afr J Reprod Health 2005; 9[1]: 128-132) Faut-il évaluer les concentrations sériques du magnesium chez les malades éclamptiques qui suivent un traitement du sulfate de magnesium? On dit que l'indice thérapeutique du magnesium est bas, donc l'on craint la toxicité quand il est employé comme un anticonvulsivant chez les malades éclamptiques. Cette étude avait pour objectif d'évaluer les concentrations sériques du magnesium chez les malades qui suivent un traitement du sulfate de magnesium et d'établir un rapport de ces concentrations avec des moniteurs cliniques. Nous avons mené une étude prospective des malades éclamptiques consécutives qui suivaient un traitement entre janvier et décembre 2002 en utilisant le sulfate de magnesium comme le seul anticonvulsivant à l'aide d'un Schéma de Pritchard modifié. Des échantillons de sang ont été prélevés avant d'administrer la dose d'attaque et la dose d'entrentien du sulfate du magnesium; des concentrations sériques du magnesium ont été estimée à l'aide d'un colorimètre de Jenway 605. Il y avait 19 malades et 72 échantillons de sang. La ligne de base moyenne de la sérique du magnesium était 0,72