Magnesium sulfate for 6 vs 24 hours post delivery in patients who received magnesium sulfate for less than 8 hours before birth: a randomized clinical trial

Paulino Vigil-De Gracia, Ricardo Ramirez, Yarelys Durán, Arelis Quintero, Paulino Vigil-De Gracia, Ricardo Ramirez, Yarelys Durán, Arelis Quintero

Abstract

Background: To compare the benefits of magnesium sulfate for 24 h (h) postpartum versus 6 h postpartum in patients who received magnesium sulfate (Mg) for less than 8 h before birth.

Methods: A randomized, multicenter, open study was conducted between November 2013 and October 2016 in three teaching maternity hospitals in Panama. Pregnant women diagnosed with severe pre-eclampsia or pre-eclampsia with severe features at more than 20 weeks gestation were invited to participate. They were randomized to the following groups in a 1:1 ratio: A- continue Mg for 24 h after birth (control group); and B- receive Mg for 6 h after birth (experimental group). The primary endpoint and variable was seizure (eclampsia) in the first 72 h postpartum.

Results: During the study period, 284 patients agreed to participate in the study; 143 were randomized to receive Mg for 24 h postpartum and 141 to receive Mg for 6 h postpartum. There were no significant differences in the baseline characteristics of the two groups studied. There was no eclampsia in the entire population; therefore, there was no significant difference in the primary variable. Two secondary variables showed a significant difference: time to onset of ambulation, which was 14 h shorter (p = 0.0001) in the group that received 6 h of postpartum Mg, and time to initiation of breastfeeding, which was 11 h earlier (p = 0.0001) in the group that received 6 h of postpartum Mg. There were not significant differences between the groups with respect to total complications or any particular complication. There were no cases of maternal death.

Conclusion: Maintaining Mg for 6 h postpartum is equally effective in preventing eclampsia as receiving Mg for 24 h postpartum in patients with severe pre-eclampsia who receive less than 8 h of Mg treatment before birth. The onset of maternal ambulation and initiation of breastfeeding are faster in patients who only receive Mg for 6 h postpartum.

Trial registration: The study was registered at clinical-trials.gov, number NCT02317146 . Date of registration: December 11, 2014. This study was registered at clinical trials after the beginning of recruitment of patients.

Keywords: Eclampsia; Magnesium sulfate; Maternal complication; Postpartum; Pregnancy; Severe preeclampsia.

Conflict of interest statement

Ethics approval and consent to participate

The ethical committee of “Complejo Hospitalario Dr. Arnulfo Arias Madrid” approved this research, CEICH“DrAAM”SS:November2013. The other hospitals accepted the research. Verbal and written consent to participate was necessary in all women.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Eligible women, randomization and follow-up of the clinical trial

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Source: PubMed

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