Comparison of Zuspan regimen and its 12-hour modification in women with severe pre-eclampsia and eclampsia in two hospitals in Abeokuta
Authors: GRILLO Elizabeth Oluwakemi, Awonuga Olalekan, Dedeke Olabisi, Abiodun O, Jimoh Saheed, NWankpa Chimaobi O
Journal: Pregnancy Hypertension: An International Journal Of Women’s Cardiovascular Health
ISSN Number:
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Abstract
Background: Hypertensive disorders in pregnancy (HDP) are leading causes of maternal mortality (with severe
pre-eclampsia/eclampsia [SPE/EC] being causes of death). Magnesium sulphate (MgSO4) has proven to be the
drug of choice for SPE/EC management. However, its availability and cost remain a drawback to its use in
developing countries. This study aimed to compare Zuspan regimen with its 12-hour modification for SPE/EC
management in two major hospitals in Abeokuta, Ogun state, South Western Nigeria.
Methods: A randomized controlled trial of non-inferior parallel design carried out at Federal Medical Centre and
Sacred Heart Hospital, Abeokuta involving 148 consenting women who were randomized into two groups A and
B. Both groups had 4 g loading dose of MgSO4, but the duration of maintenance was reduced to 12-hours in
Group A (intervention) while Group B received the standard Zuspan regimen (control). Outcome measures were
the occurrence/recurrence of convulsions (primary), maternal side effects and perinatal outcomes (secondary).
Results: There was no statistically significant difference in the occurrence/recurrence of seizures between the two
groups for both SPE/EC. No signs of maternal toxicity were observed in both arm of the study. There were no
statistically significant differences in the perinatal/neonatal death and Apgar scores at 1 and 5 min. However,
there was a significant increase in the number of days on admission in the control group of those neonates
delivered to mothers with eclampsia.
Conclusion: A 12-hr modification of Zuspan regimen was found to be non-inferior to the standard Zuspan regimen
in the management of SPE/EC.
