Should we Systematically Measure Plasma Magnesium Levels in the Treatment of Severe Preeclampsia/Eclampsia?

To show that measuring magnesium levels optimizes magnesium sulfate treatment in severe preeclampsia/eclampsia. Subjects and methods: A retrospective study was conducted with severe preeclampsia/eclampsia patients who have been treated with magnesium sulfate and have received magnesium in biological monitoring. Results: Ten patients were treated for severe pre-eclampsia/eclampsia during the study period. Of these, six patients with, an average age of 27.5 years had their plasma magnesium measured through treatment monitoring. The average rate of ionized magnesium was 1.4 (1-13.6 mEq/l). Plasma levels were supratherapeutic (> 4 mmol/l) for two patients. The other four patients had subtherapeutic plasma levels. Clinical signs of overdose were seen in one case, where plasma magnesium levels were 1,8mEq/l. At admission, the average systolic blood pressure was 137.5mmHg (120-147mmHg), and the average diastolic blood pressure was 80.5 mmHg (69-106mmHg). Complications included hemodynamic pulmonary edema (2 cases) and nosocomial bacterial pneumonia (1 case). The average length of stay was 4 days (1-8 days), and there was no hospital mortality. Conclusion: The results suggest a need for systematic measurement of plasma magnesium levels in severe preeclampsia/eclampsia treated with magnesium sulfate. A larger study is needed to build consensus regarding this practice.