Maternal and Fetal Outcomes After Introduction of Magnesium Sulphate for Treatment of Preeclampsia and Eclampsia in Selected Secondary Facilities: A Low-Cost Intervention

• Published in: Maternal and child health journal 2013-09, Vol.17 (7), p.1191-1198
• Main Authors: Tukur, Jamilu, Ahonsi, Babatunde, Mohammed Ishaku, Salisu, Araoyinbo, Idowu, Okereke, Ekechi, Babatunde, Ayodeji Oginni
• Format: Article
• Language: English
• Subjects: Births; Care and treatment; Childrens health; Collaboration; Developing countries; Eclampsia; Eclampsia - drug therapy; Eclampsia - mortality; Evidence-Based Medicine; Fatalities; Female; Gynecology; Health aspects; Health facilities; Health Personnel - education; Hospitals; Hospitals, Teaching; Humans; Hypertension; International organizations; LDCs; Magnesium sulfate; Magnesium Sulfate - therapeutic use; Male; Maternal and Child Health; Maternal mortality; Maternal Mortality - trends; Medical personnel; Medicine; Medicine & Public Health; Middle Aged; Nigeria - epidemiology; Patient outcomes; Pediatrics; Perinatal Mortality - trends; Population Economics; Pre-Eclampsia - drug therapy; Pre-Eclampsia - mortality; Preeclampsia; Pregnancy; Pregnancy Outcome - epidemiology; Public Health; Severity of Illness Index; Sociology; Sulfates; Tocolytic Agents - therapeutic use; Treatment Outcome; Womens health
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-012-1105-9

The aim of this study was to evaluate whether a new low-cost strategy for the introduction of magnesium sulphate (MgSO 4 ) for preeclampsia and eclampsia in low-resource areas will result in improved maternal and perinatal outcomes. Doctors and midwives from ten hospitals in Kano, Nigeria, were trained on the use of MgSO 4 . The trained health workers later conducted step-down trainings at their health facilities. MgSO 4 , treatment protocol, patella hammer, and calcium gluconate were then supplied to the hospitals. Data was collected through structured data forms. The data was analyzed using SPSS software. From February 2008 to January 2009, 1,045 patients with severe preeclampsia and eclampsia were treated. The case fatality rate for severe preeclampsia and eclampsia fell from 20.9 % (95 % CI 18.7–23.2) to 2.3 % (95 % CI 1.5–3.5). The perinatal mortality rate was 12.3 % as compared to 35.3 % in a center using diazepam. Introduction of MgSO 4 in low-resource settings led to improved maternal and fetal outcomes in patients presenting with severe pre-eclampsia and eclampsia. Training of health workers on updated evidence-based interventions and providing an enabling environment for their practice are important components to the attainment of the Millenium Development Goals (MDG) in developing countries.