INTRODUCTION DU SULFATE DE MAGNESIUM DANS LA PRISE EN CHARGE DE LA PREECLAMPSIE SEVERE AU CHUGOB
DOI:
https://doi.org/10.53555/eijmhs.v6i1.131Keywords:
Eclampsia, Severe preeclampsia, Magnesium sulphate, ManagementAbstract
Introduction: Preeclampsia is a major cause of maternal and newborn morbi-mortality mostly through eclampsia and its complications. Magnesium sulphate is now approved to prevent eclamptic seizures. Our survey is aimed at showing the benefits and risks of its use in the management of severe preeclampsia.
Methods: A prospective and descriptive study was led for nine months from April to December 2016 at CHUGOB about 90 severe preeclamptic women up to 28 weeks of gestation with imminent eclampsia and/or decision of delivery (or in labor); treated by magnesium sulphate before, during and/or after delivery.
Results: The prevalence of this pathology was 1, 9%. It occurred before 37 weeks of gestation in 62, 22% of the cases, with middle age of 28, 89 years old. Systolic arterial blood pressure was greater than 160 mmHg (92, 22%), accompanied by significant proteinuria (61, 11%), and clinical signs of imminent eclampsia (65, 56%). Fifty five of them (61, 11%) needed antihypertensive therapy. The mainly side effects were minor (feeling of warmth in 54, 44%). There were six overdoses which regressed when treatment was stopped and calcium gluconate administered. No patients had eclampsia nor death. The newborn morbi-mortality hadn’t been affected.
Conclusion: Magnesium sulphate is effective especially in imminent eclampsia. The benefits from its use were above the risks for the mother and her baby with rigorous clinic follow up.
We recommend it.
References
. ACOG practice bulletin no 33. Diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol. 2002; 99:159-67.
. Pottecher T, Luton D, Zupan V, Collet M. Prise en charge multidisciplinaire de la prééclampsie: Recommandations formalisées d’experts communes. Ann Fr Anesth Réanim. 2009 Mars;28(3):275-81.
. Rakotomahenina H, Rajaonarison J, Randriamahavonjy R, Andrianampanalinarivo H.
a. Pourquoi l’éclampsie engendre une forte mortalité ? Une étude dans la Maternité de Befelatanana. Rev Afr Anest Méd Urg. 2009 (July-August);1(3):25-7
. Goita L. Intérêt du sulfate de magnésium dans la prise en charge de la prééclampsie sévère du CHU Gabriel Touré [Thèse]. Médecine humaine: Bamako; 2008. 101p.
. Lokossou A, Avode D, Komongui D, Takpara I, Sacca P, Perrin R. Prise en charge des manifestations neurologiques de la prééclampsie sévère et de l’éclampsie par le sulfate de magnésium à Cotonou. Afr J Neurol Sci. 2006;25(1):41-9.
. Girard B, Bencher G, Muris C, Simonet T, Dreyfus M. Sulfate de magnésium et préeclampsie sévère: innocuité en pratique courante dans des indications ciblées. J Gynecol obstet Biol Reprod. 2005;34(1):17-22.
. Naeimi A, Rieu M, Le Guen F, Marpeau L. Sulfate de magnésium en prévention de l’éclampsie à propos de 105 cas. Gynecol Obstet Fertil. 2014;42:322-4.
. Malek M, Youssef A, Fethi BA et al. Sulfate de magnésium au cours de la prééclampsie sévère: Innocuité d’utilisation. Tun Med. 2012;90(7):552-6
. Rachdi R, Kaabi M, Zayene H. Pronostic maternel et fœtal au cours de la toxémie gravidique sévère. Tun Med. 2005;83:67-71.
. The Eclampsia Trial Collaborative Group. Which anticonvulsant for women with eclampsia? Evidence from the collaborative Eclampsia Trial. Lancet. 1995;345:145563
. The Magpie trial Group. Do women with pre-eclampsia and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomized placebo controlled trial. The Magpie trial collaborative Group. Lancet. 2002;359:1877-90.
. Belfort MA, Anthony J, Saade GR, Allen JC. A comparison of magnesium sulfate and nimodipine for the prevention of eclampsia. N Engl J Med. 2003; 348:304-11.
. Coetzee E, Dommisse J, Anthony J. A randomized controlled trial of intravenous magnesium sulfate versus placebo in the management of women with severe preeclampsia. Br J Obstet Gynaecol. 1998;105:300-3.
. The Magpie trial Group. Do women with pre-eclampsia and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomized placebo controlled trial. The Magpie trial collaborative Group. Lancet. 2002;359:1877-90.
. Cortot F, Pottecher T. Indications et utilisation pratique du sulfate de magnésium en obstétrique. In: Mises à jour en Gynécologie Obstétrique du Collège National des Gynécologues Obstétriciens Français (CNGOF). Diffusion Vigot- Paris; 2006; T. XXX:39-54.
. Beucher G, Dreyfus M. Pour l’utilisation du sulfate de magnésium dans la prévention de la crise d’éclampsie en cas de prééclampsie. Gynecol Obstet Fertil. 2010;38:155-8
. Mandji L. Efficacité du sulfate de magnésium dans la prévention et le traitement de la crise de l’éclampsie SARANF. Rev Afr Anesth Med Urg. 2013;18(3).
. Rozenberg P. Intérêt du sulfate de magnésium dans la prise en charge de la preeclampsia. Gynecol Obstet Fertil. 2006;34:54-9.
. Duley L, Gulmezoglu AM, Henderson-Smart DJ. Magnesium sulphate and other anticonvulsants for women with preeclampsia. Cochrane Database Syst Rev 2003. CD000025.
. Atallah AN. Traitement par anticonvulsivants en cas d’éclampsie: aspects pratiques de la Bibliothèque de Santé Génésique de l’OMS. BSG. Novembre 2003.
. Sibai BM. Magnesium sulphate prophylaxis in preeclampsia: Lessons learned from recent trials. Am J Obstet Gynecol. 2004;190:1520-6.
. . Isler CM, Barrilleaux PS, Rinehart BK, Magann EF, Martin Jr JN. Postpartum seizure prophylaxis: Using maternal clinical parameters to guide therapy. Obstet Gynecol. 2003;101:66-9.
. Fontenot MT, Lewis DF, Frederick JB, Wang Y, Defranco EA, Groome LJ et al. A prospective randomized trial of magnesium sulfate in severe preeclampsia: Use of diuresis as a clinical parameter to determine the duration of postpartum therapy. Am J Obstet Gynecol. 2005;192:1788-93.
. Andriambololonanahary HN. Aspect épidémio-clinique de la prééclampsie sévère au CHUGOB en 2014 [Thèse]. Médecine Humaine: Antananarivo; 2015. 61p.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.