Serum Magnesium Level in Severe Preeclampsia and Eclampsia Undergoing Magnesium Sulfate Therapy at Chonburi Hospital

Abstract

Objectives:  To evaluate the level of serum magnesium in pregnant women with severe preeclampsia and eclampsia who received magnesium sulfate therapy and to determine the factors affecting nontherapeutic magnesium level at Chonburi Hospital.

Study design:  Prospective descriptive study.

Materials and Methods: The data from 146 pregnant women with severe preeclampsia and eclampsia receiving magnesium sulfate therapy at Chonburi Hospital from October 1, 2007 to September 30, 2008 were collected. Blood sample for serum magnesium level was taken at the third hour after loading dose of magnesium sulfate. Multiple logistic regression was employed and the calculation were done on the following factors; age, body mass index (BMI), gestational age, gestational diabetes mellitus (GDM) and other underlying disease to find out the significant factors affecting nontherapeutic magnesium level. 

Results:  The mean of serum magnesium level was 4.9+1.9 mg/dL. Only 67 patients (45.9%) were in the therapeutic range (4.8-8.4 mg/dL). The GDM was significantly associated with nontherapeutic serum magnesium level. (p=0.03)

Conclusion:  Magnesium sulfate is now the gold standard drug for preventing seizure in pregnant women with severe preeclampsia and eclampsia. In 54.1% of pregnant women who receiving the loading dose of magnesium sulfate 4 gm followed by a maintenance infusion of 1 gm/hr had inadequate therapeutic level, and GDM was a statistical significantly associated factor.