Preeclampsia Clinical Trial
Official title:
Effectiveness and Safety of 1g/Hour vs. 2g/Hour of Magnesium Sulfate Maintenance Dose for Eclampsia Prevention: Randomized Clinical Trial
Eclampsia is an obstetric emergency capable of prophylaxis. To prevent and control seizures, there is no doubt that the magnesium sulfate (MgSO4) is the ideal drug. However, there are still questions regarding its use and dose. The scheme and the optimal time of administration remain to be elucidated. The objective of this trial is to compare the effectiveness and safety of intravenous magnesium sulfate in the maintenance phase 1g / h versus 2 g / h to prevent eclampsia in pregnant and postpartum women with severe preeclampsia (pure or superimposed).
Hypertensive disorders are frequent during the course of pregnancy-puerperal cycle and an
important cause of maternal morbidity and mortality, fetal and perinatal. The high frequency
of maternal death can be explained by the presence of numerous complications such as
eclampsia. Eclampsia is an obstetric emergency capable of prophylaxis. To prevent and
control seizures, there is no doubt that the magnesium sulfate (MgSO4) is the ideal drug.
However, there are still questions regarding its use and dose. The scheme and the optimal
time of administration remain to be elucidated. Currently, allows the use of either 1 g / h
to 2 g / h of magnesium sulphate during the maintenance phase to prevent eclamptic
convulsions. However, there is no report in the literature of randomized controlled trials
comparing different doses of magnesium sulfate in the maintenance phase to prevent
eclampsia.
The objective of this study is to compare the effectiveness and safety of intravenous
magnesium sulfate in the maintenance phase 1g / h versus 2 g / h to prevent eclampsia in
pregnant and postpartum women with severe preeclampsia (pure or superimposed).There will be
a trial randomized and triple blind in the Integrative Medicine Institute Prof. Fernando
Figueira (IMIP) from March 2015 to April 2017, and will be included 2000 women randomized
into two groups: MgSO4 maintenance dose of 1 g / h or 2 g / h. Patients who had eclampsia
before loading dose, with use of other medications or illicit drugs that may interfere with
maternal hemodynamics or with contraindications to the use of magnesium sulfate will be
excluded. The primary endpoint will be the incidence of eclampsia. Other complications such
as oliguria, bleeding, recurrence of seizures, disseminated intravascular coagulation,
maternal death, presence of side effects related to the use of MgSO, neonatal outcome and
other variables will be considered secondary outcomes. Randomization for preventive
treatment of eclamptic seizures with MgSO4 1g / h or MgSO4 2g / h will be held according to
a table of sequential numbers from one to 2000, using the letters A and B and not knowing
its meaning. The analysis will be performed with the groups identified as A or B, breaking
the secrecy only after the results obtained and prepared the tables, or by resolution of the
External Monitoring Committee.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Prevention
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