Comparing a 12 versus 24-h postpartum IV magnesium protocol for preeclampsia with severe features at an academic-affiliated community hospital

Abstract

Objective

To compare the safety and efficacy of 12 versus 24-h postpartum magnesium sulfate (MgSO₄) infusion protocol in women with severe preeclampsia.

Methods

This retrospective cohort study analyzed patient outcomes before and after a postpartum magnesium protocol change for cases of severe preeclampsia: 24-h MgSO₄ (Feb–Sep 2021) versus 12-h MgSO₄ (Sep 2021–Feb 2023). The primary outcome was eclampsia; secondary outcomes included magnesium toxicity, maternal complications, postpartum length of stay, ambulation time, and time to Foley catheter removal.

Results

Baseline characteristics were similar. No cases of eclampsia occurred in either protocol. Magnesium toxicity and maternal complications were comparable. Notably, 10 out of the 75 patients in the 12-h protocol required magnesium extension due to persistent preeclampsia symptoms. However, the 12-h protocol was associated with shorter postpartum stay, earlier ambulation, and earlier time to Foley catheter removal.

Conclusion

The 12-h MgSO₄ protocol is as safe and effective as the 24-h protocol. There were no differences in rates of convulsion or negative maternal outcomes between the two protocols.