الفهرس 
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Abstract
Preeclampsia is a significant source of maternal and neonatal morbidity and mortality, complicating 5–8% of all deliveries. Treatment of preeclampsia at term typically includes delivery, administration of parenteral magnesium sulfate for seizure prophylaxis, and management of the attendant severe hypertension and other acute complications. There is currently no consensus regarding the appropriate duration of postpartum seizure prophylaxis.
Magnesium sulfate therapy carries risk of fluid overload, pulmonary edema, inadvertent overdose with cardiopulmonary depression, and nausea and vomiting with attendant risks of aspiration in the obtunded patient. In light of these risks, postpartum women being treated with MgSO4 require more intensive nursing care, often at the expense of appropriate bonding with and breastfeeding of the newborn due to staffing limitations in the labor and delivery suite.
Recently, shorter duration postpartum MgSO4 therapy has been suggested. Proposed treatment schemes have included shortened courses for selected patients at low risk for eclampsia. The current study was conducted at The Department of Obstetrics and Gynaecology (Women’s Health Hospital), Assiut University, Assiut, Egypt. It was performed in the period between October 2020 and November 2022.
The study aimed to compare the use of magnesium sulphate for 12 hours versus 24 hours in postpartum women with pre-eclampsia with severe features, to ensure maximum efficacy of anticonvulsant action that can be achieved with least exposure to magnesium sulphate side effects. A total of 280 women with severe preeclampsia were enrolled in the study. those patients were randomly subdivided into group 1): received Mgso4 12- hour after delivery maintained at 1g per hour for 12 h and group 2): received Mgso4 24-hour after delivery maintained at 1g per hour for 24 h.
The main findings of this study were; 1) both groups had insignificant differences baseline clinical, obstetric, intrapartum and antepartum data, 2) three patients required prolongation of MgSo4 in 12-hours group, 3) 12-hours group had significantly shorter duration of urinary catheter and hospital stay, 4) none woman developed eclampsia and 5) one woman in 24 hours group developed oliguria.
In conclusion, compared to continuation of magnesium for 24-hours postpartum, 12-hours magnesium postpartum therapy does not significantly increase the rate of prolongation of magnesium therapy or postpartum eclampsia. Additional benefits of shorter postpartum regimen may include reduction of the risk of drug toxicity, and side effects of more injections.
It’s recommended to perform such studies in multiple centers on large number of patients. Also, it’s better to enrolled all cases of preeclampsia with no restriction to only severe cases. Also, the future studies should be focused on cost benefit analysis and degree of patients’ satisfaction.
Conclusions
12-hour MgSO4 regimen may be a safe and effective alternative to the traditional 24-hour regimen for the prevention of pre-eclampsia in postpartum women with pre-eclampsia with severe features. Both 12-hour and 24-hour magnesium sulfate (MgSO4) regimens were equally effective in preventing the development of eclampsia.