Volume 9, Issue 4 (2025)
SJMR 2025, 9(4): 201-210 |
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Nateghi M R, Sanaye Naderi M, saremi A. Preeclampsia Management by Magnesium Sulfate: The Sarem Women’s Hospital Protocol. SJMR 2025; 9 (4) : 2
URL: http://saremjrm.com/article-1-347-en.html
URL: http://saremjrm.com/article-1-347-en.html
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
Abstract: (761 Views)
Introduction: Preeclampsia and eclampsia are among the top three causes of maternal mortality worldwide, accounting for 10 to 25% of such deaths. Preeclampsia is defined as a condition in pregnant women at or beyond 20 weeks of gestation, characterized by a diastolic blood pressure of 90 mmHg or higher and significant proteinuria. In 1925, magnesium sulfate was introduced into clinical practice to treat eclampsia. The primary objective of this study was to present the successful protocol for magnesium sulfate dosage in the treatment of preeclampsia in the study population, resulting in zero mortality at the Sarem Women’s Hospital in Tehran.
Materials and Methods: According to this protocol, mothers with non-severe preeclampsia were hospitalized, and decisions were made based on gestational age, with initial care provided. After initial care, if the gestational age was 37 weeks or more, labor induction was initiated, and magnesium sulfate was administered during the active phase of labor. However, if the gestational age was less than 37 weeks, symptoms were closely monitored, and initial care was continued until delivery. The primary medication for controlling and preventing seizures was magnesium sulfate, administered at a dose of 4 to 6 grams dissolved in 100 ml of Ringer's solution or normal saline throughout 15 to 20 minutes. Due to the high dose of magnesium sulfate, monitoring for toxicity was conducted, and calcium gluconate was readily available.
Results: A 10-year review of data from Sarem Women’s Hospital showed that among 41,102 patient visits, 463 cases were severe preeclampsia and 166 cases were mild preeclampsia. With the implementation of this treatment protocol, the mortality rate reached zero. This statistic is considered a significant achievement for the institution. The majority of the patients were primigravida (gravida 1) and nulliparous (para 0), with no reported abortions. 90% of the pregnancies involved singletons, and proteinuria was not commonly observed. Fetal hypoxia was reported in only one case, and most cases did not have intrauterine growth restriction (IUGR). None of the newborns had congenital anomalies.
Conclusion: The Sarem Women’s Hospital's magnesium sulfate protocol for the management of preeclampsia is a completely safe treatment method that has reduced mortality to zero and is associated with minimal maternal and fetal complications. It can be a suitable treatment protocol for use in all medical centers for the control of preeclampsia.
Materials and Methods: According to this protocol, mothers with non-severe preeclampsia were hospitalized, and decisions were made based on gestational age, with initial care provided. After initial care, if the gestational age was 37 weeks or more, labor induction was initiated, and magnesium sulfate was administered during the active phase of labor. However, if the gestational age was less than 37 weeks, symptoms were closely monitored, and initial care was continued until delivery. The primary medication for controlling and preventing seizures was magnesium sulfate, administered at a dose of 4 to 6 grams dissolved in 100 ml of Ringer's solution or normal saline throughout 15 to 20 minutes. Due to the high dose of magnesium sulfate, monitoring for toxicity was conducted, and calcium gluconate was readily available.
Results: A 10-year review of data from Sarem Women’s Hospital showed that among 41,102 patient visits, 463 cases were severe preeclampsia and 166 cases were mild preeclampsia. With the implementation of this treatment protocol, the mortality rate reached zero. This statistic is considered a significant achievement for the institution. The majority of the patients were primigravida (gravida 1) and nulliparous (para 0), with no reported abortions. 90% of the pregnancies involved singletons, and proteinuria was not commonly observed. Fetal hypoxia was reported in only one case, and most cases did not have intrauterine growth restriction (IUGR). None of the newborns had congenital anomalies.
Conclusion: The Sarem Women’s Hospital's magnesium sulfate protocol for the management of preeclampsia is a completely safe treatment method that has reduced mortality to zero and is associated with minimal maternal and fetal complications. It can be a suitable treatment protocol for use in all medical centers for the control of preeclampsia.
Article number: 2
Keywords: ش
Article Type: Original Research |
Subject:
Childbirth
Received: 2024/12/30 | Accepted: 2025/02/13 | Published: 2025/03/6
Received: 2024/12/30 | Accepted: 2025/02/13 | Published: 2025/03/6
Blood pressure during pregnancy [JPG 2836 KB] (39 Download)
Magnesium sulfate protocol [JPG 557 KB] (54 Download)
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