A COMPARATIVE CLINICAL STUDY OF DHAKA AND PRITCHARD REGIME IN THE ECLAMPSIA MANAGEMENT

Abstract

G. Sunanda Bai1

INTRODUCTION: The safety and efficacy of low dose Magnesium Sulphate regime in the management of Antepartum/Intrapartum/Postpartum eclampsia patients. METHODS: This study was conducted at Bowring and Ladycurzon Hospital in the Department of Obstetrics and Gynaecology BMCRI Bengaluru during the period of April 2013 to April 2014 100 eclampsia patients including antepartum eclampsia, intrapartum eclampsia, post-partum eclampsia were included for the purpose of this study. Magnesium Sulphate was used for the management of eclampsia. 50 eclamptic patients were treated with Pritchard regimen and other 50 with Dhaka regimen. Hypertension is treated with antihypertensive drugs. A detailed history, examination was done. In the present study 25 patients were below 20 years. In the study group 26 patients were between 28 to 37 weeks. 18 were more than 37 weeks. 6 patients were below 28 weeks. In patients treated under Pritchard regimen 44 were admitted in conscious state. Under Dhaka regimen 44 were conscious. In Dhaka regimen 28 patients had systolic BP above 161mm Hg, under Pritchard 22 had systolic BP above 161mmHg. 18 Patients under Dhaka regimen had more than 110mmHg diastolic BP. In Pritchard regime 19 patients had diastolic BP more than 110mmHg. In patients treated with Dhaka regimen 26 underwent LSCS/Hysterectomy. In patients treated with Pritchard 26 were underwent LSCS. In Dhaka regimen 2 patients had abruption, 1 had HELLP and 5 had pulmonary edema. One patient developed occipital lobe infarct. In Pritchard regime 2 had abruption. 1 patient had HELLP and 2 had pulmonary edema. Out of the 100 patients, 98 were discharged from the hospital without any sequlae. 2 patients died due to complication of eclampsia. 10 perinatal death in Dhaka regime, 13 perinatal death in Pritchard regime. RESULTS: This present study compared the efficacy of low dose MgSO4 with standard Pritchard regime. This study showed that recurrence of fits, maternal mortality, maternal morbidity and perinatal outcome were not statistically significant between Dhaka regime and Pritchard regime.

CONCLUSION: In this present study 100 patients of eclamptic women irrespective of the type of eclampsia (Antepartum/ Intrapartum/ Postpartum) were included. 50 patients were treated under Dhaka regimen. Another 50 eclamptic patients were treated under Pritchard regime. And the two group of patients were observed for the recurrence of fits, maternal morbidity, mortality as well as for perinatal outcome.

image