Similar Outcomes among Women Treated with 12-Hour Compared with 24-Hour Postpartum Magnesium Sulfate for Preeclampsia

Summary

Magnesium sulfate is an effective therapy for preventing or stopping seizures in pregnant women with preeclampsia. Although the standard duration of therapy is for 24 hours postpartum, the optimal length is controversial. Few studies have investigated the efficacy of a shortened duration of magnesium sulfate therapy. The objective of this study was to assess the effects of 12 hours of magnesium sulfate compared with 24 hours of treatment in postpartum women with severe preeclampsia [Leal V et al. Obstet Gynecol 2014].

  • Pregnancy
  • Hypertensive Disease Clinical Trials
  • Pregnancy
  • Hypertensive Disease
  • Obstetrics & Gynecology Clinical Trials
  • Obstetrics & Gynecology

Magnesium sulfate is an effective therapy for preventing or stopping seizures in pregnant women with preeclampsia. Although the standard duration of therapy is for 24 hours postpartum, the optimal length is controversial. Few studies have investigated the efficacy of a shortened duration of magnesium sulfate therapy. The objective of this study, presented by Nicole V. Leal, Institute Paraibano de Pesquisa, Paraibo, Brazil, was to assess the effects of 12 hours of magnesium sulfate compared with 24 hours of treatment in postpartum women with severe preeclampsia [Leal V et al. Obstet Gynecol 2014].

A total of 120 postpartum women with severe preeclampsia were enrolled in this open-label, randomized clinical trial. The women were randomized to therapy with magnesium sulfate for 12 hours (n=60) or 24 hours (n=60). The data were analyzed on an intention-to-treat basis, and the intervention was not masked.

Women treated for 12 hours had decreased exposure to magnesium sulfate compared with those treated for 24 hours. Clinical outcomes were similar in both groups, and no cases of eclampsia were diagnosed in either group. There was no need to reinitiate treatment with magnesium sulfate in either group after the scheduled course of therapy was completed. Of note, magnesium sulfate therapy was extended in 3 of the women receiving the therapy for 12 hours. Women in the 12-hour treatment group had significant reductions in the duration of postpartum indwelling bladder catheter use and in the time they were required to be on bed rest. The interval between delivery and maternal contact with the newborn infant also was significantly reduced in women in the 12-hour magnesium sulfate therapy group compared with those in the 24-hour magnesium sulfate therapy group.

The investigators concluded that treatment with postpartum magnesium sulfate for 12 hours instead of 24 hours is associated with decreased overall exposure to magnesium sulfate, a shorter interval between delivery and maternal-newborn bonding, decreased indwelling catheter time, and a quicker return to ambulation.

View Summary