MANAGEMENT OF PRE-ECLAMSIA AND ECLAMPSIA WITH MAGNESIUM SULPHATE (MgSO4)

Different between healthy Uterus [left]
and pre-eclampsia affected uterus [right]

In managing pre-eclampsia  and eclampsia by using magnesium Sulphate injection we have two major steps which are:

1. Loading Dose and

2. Maintenance Dose

LOADING DOSE

During Loading Dose management ,Prepare 4gm of Magnesium Sulphate injection(MgSO4) IV as 20% From A solution of Magnesium Sulphate  50%, Then by using a syringe of 20cc=20mls Draw 8mls Of 50% Magnesium Sulphate solution Then Add 12mls of Water for injection to make up 20mls of 20% Then give it to a patient slowly over 5minutes.

After that follow promptly with 10gm as 50% of Magnesium Sulphate Solution deep IM.

-Using two 10cc syringes, Draw 10mls of 50% Magnesium Sulphate solution into each syringe then add 1ml of Lignocaine 2% in each syringe and Give it deep IM in each buttock in which each buttock will be administered 10mls of Magnesium solution.

If fits occur within 15minutes by using 10cc syringe draw 4mls of 50% magnesium Sulphate  solution(MgSO4) then add 6mls of water for injection to make up 10mls then give it IV slowly over 5minutes.

MAINTENANCE DOSE

Eclampsia

During maintenance dose Management, Prepare 5gm as of 50% Magnesium Sulphate solution Give it inaltenate buttocks every 4hours. 

That means;

By using 10cc syringe=10mls Draw 10mls of Magnesium Sulphate solution 50% then add 1ml of lignocaine 2% and give it to a patient deep IM in each Buttock every 4hours.Cntinue some treatment for 24hours after delivery or last fit.

NOTE; MONITOR FOR TOXICITY

Withhold or Delay Magnesium Sulphate if any of the following occurs

• Respiratory rate less than 16/minutes

• Patellar reflexes absent

• Urine output less than 30mls/hr.

Remember the Antidote of Magnesium Sulphate is Calcium Gluconate 1gm (10mls) of 10% given IV slowly over 10minutes.