Essay On Preeclampsia

Hypertensive disorders of pregnancy contribute to significant maternal and perinatal morbidity and mortality in both developed and developing countries. Pre-eclampsia and eclampsia affects 5-10% of all the pregnancies and contributes to 10-15% of maternal deaths worldwide. Estimated case fatality rate due to eclampsia is 14 times higher in developing countries compared to developed countries 1,2. Preeclampsia is a multi-system disorder whose pathophysiology remains unclear. Preeclampsia is defined as a blood pressure of at least 140 mmHg systolic pressure and 90 mmHg diastolic pressure measured on two occasions 6 hours apart, accompanied by proteinuria of at least 300 mg per 24 hours, or at least 1+ on dipstick testing after 20 weeks3. Eclampsia refers to the onset of convulsions in a woman with

It has been proved superior to diazepam with low seizure recurrence, quick recovery from coma and with improved fetal salvagability31. Magnesium sulfate can be administered parenterally by intramuscular(IM) or intravenous (IV) routes. Though IV regimen is more efficacious in achieving stable serum levels of magnesium but requires the use of an infusion pump for safe delivery of drug and has a greater potential for inadvertent overdose. But in low resource setting or developing countries like India the use of IV infusion set is not uncommon. So IM regimen is the standard of care used in most hospitals in India. Though it is potentially safer it requires repeated IM injections which are painful. To reduce the pain at injection site due to repeated injections, WHO recommends addition of 1ml of 2% Lignocaine to 2.5mg(5ml)/ 5mg(10ml) of Magnesium Sulphate during IM use. This recommendation is consensus based and not evidence