Maternal and perinatal outcome of patients with severe pre-eclampsia in a tertiary health centre in south-western Nigeria: a cohort study
Keywords:
Severe pre-eclampsia, seizure prophylaxis, perinatal mortality, magnesium sulfateAbstract
Objective: To determine the effect of introducing MgSO4 on the maternal and perinatal outcomes of severe pre-eclampsia in Sagamu, south-western Nigeria.
Methods: A retrospective cohort study of all cases of severe pre-eclampsia managed at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria from 1 January 2001 to 31 December 2012 – 6 years before and 6 years after the introduction of MgSO4 was carried out.
Results: The prevalence of severe pre-eclampsia within the study period was 4.2%. The mean age of study participants was 31.2 ± 6.7 years. Seventy-four women received MgSO4 while 123 received diazepam. Eclampsia occurred in 3 members of the diazepam group and none in the MgSO4 group. There were no maternal deaths. Babies from the diazepam group were more likely to have low Apgar score at 5 minutes (though the association was not statistically significant [OR=1.47, 95% CI 0.76, 2.82]).Babies from the diazepam group were significantly more likely to have prolonged hospital stay [OR= 6.09, CI 2.25, 17.40; p< 0.001] and suffer early neonatal deaths than babies from the MgSO4 group [OR= 5.26, CI 1.35, 23.92; p= 0.005]. Perinatal mortality did not differ between the groups.
Conclusion: MgSO4 is more effective than diazepam in the management of severe pre-eclampsia at OOUTH, Sagamu, Nigeria. Therefore, its accessibility and wider use should be promoted to improve fetomaternal outcome.
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