Benefits of using magnesium sulphate (MgSO₄) for eclampsia management and maternal mortality reduction: lessons from Kano State in Northern Nigeria.
Benefits of using magnesium sulphate (MgSO₄) for eclampsia management and maternal mortality reduction: lessons from Kano State in Northern Nigeria.
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DOI：
10.1186/1756-0500-5-421
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发表时间：
2012-08-08
影响因子：
1.8
通讯作者：
Oginni AB
中科院分区：
文献类型：
--
作者：
Okereke E;Ahonsi B;Tukur J;Ishaku SM;Oginni AB
尽管千年发展目标明确强调，但产妇死亡率高的问题仍然存在，特别是在低收入和中等收入国家。各种研究报告称，尼日利亚北部的孕产妇死亡率非常高，每10万活产的孕产妇死亡率超过1 000人，子痫约占孕产妇死亡的40%。在尼日利亚，地西泮通常用于治疗子痫。2008年2月以前，地西泮被广泛用于卡诺州（尼日利亚北部）的子痫治疗，病死率超过20%。虽然硫酸镁（MgSO4）被认为是治疗子痫最有效的药物；本研究旨在比较MgSO4治疗与地西泮治疗在病死率和成本方面的差异。这项回顾性研究包括2008年和2009年1045例子痫和先兆子痫患者，报告在MgSO4干预后，子痫患者的病死率从20.9% （95% CI: 18.7, 23.2）下降到2.3% （95% CI: 1.4, 3.2）。研究发现，与地西泮治疗相比，MgSO4治疗的成本没有显著差异。该研究发现，与地西泮治疗相比，接受MgSO4治疗的患者因子痫导致的病死率显著降低，而费用增加最少。协调一致的努力应集中在适当地将MgSO4引入紧急产科协议，特别是在发展中国家，以降低孕产妇死亡率并对卫生系统绩效产生影响。
Despite clear emphasis through the Millennium Development Goals, the problem of high maternal mortality persists especially within low and middle income countries. Various studies report remarkably high maternal mortality rates in northern Nigeria, where maternal mortality rates exceed 1,000 deaths per 100,000 live births and eclampsia contributes approximately 40% of maternal deaths. Across Nigeria, diazepam is routinely used for the management of eclampsia. Prior to February 2008, diazepam was widely used for the management of eclampsia in Kano State (within northern Nigeria) with case fatality rate being over 20%. While magnesium sulphate (MgSO4) is recognized as the most effective drug for the management of eclampsia; this study aims to compare MgSO4 therapy with diazepam therapy in terms of case fatality rates and costs. This retrospective study, including 1045 patients with eclampsia and pre-eclampsia during the years 2008 and 2009, reports a drop in case fatality rates from 20.9% (95% CI: 18.7, 23.2) to 2.3% (95% CI: 1.4, 3.2) among eclampsia patients following the MgSO4 intervention. The study observed no significant difference in the cost of using MgSO4 therapy compared to diazepam therapy. The study found a remarkable reduction in case fatality rate due to eclampsia in those who received MgSO4 therapy with minimal increase in costs when compared to diazepam therapy. Concerted efforts should be focused on properly introducing MgSO4 into emergency obstetric protocols especially within developing countries to reduce maternal mortality and also impact on health system performance.