Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 2/2012

01.08.2012 | Maternal-Fetal Medicine

Comparison of magnesium sulfate and mannitol in treatment of eclamptic women with posterior reversible encephalopathy syndrome

verfasst von: Bilge Cetinkaya Demir, Kemal Ozerkan, Sevda Erer Ozbek, Nalan Yıldırım Eryılmaz, Gokhan Ocakoglu

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2012

Einloggen, um Zugang zu erhalten

Abstract

Objective

To evaluate and compare the effectiveness of magnesium sulfate (MgSO4) and mannitol in the treatment of posterior reversible encephalopathy syndrome (PRES) in eclamptic women.

Study design

This retrospective analysis includes 62 eclamptic women between 22 and 40 weeks of gestation who were diagnosed with PRES in a tertiary care center. To treat neurological symptoms, 34 women received magnesium sulfate (Group 1) and the remaining 28 received 20% mannitol (Group 2) at the discretion of treating physician.

Results

Ten patients from both Group 1 (29%) and Group 2 (35.7%) were normotensive at admission. 59 of 62 patients presented with seizure. All patients underwent fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI). Parietooccipital region and cerebellum were the most commonly affected areas. The duration of treatment was significantly shorter in Group 1 than Group 2 (p < 0.001). Neurological examinations and the recovery after treatment were significantly better in favor of MgSO4 group (p = 0.039).

Conclusion

Mannitol is not superior to magnesium sulfate in achieving neurological recovery. Magnesium sulfate seems to be the agent of choice for treatment of PRES.
Literatur
1.
Zurück zum Zitat Sibai BM, Eclampsia VI (1990) Maternal-perinatal outcome in 254 consecutive cases. Am J Obstet Gynecol 163:1049–1055PubMed Sibai BM, Eclampsia VI (1990) Maternal-perinatal outcome in 254 consecutive cases. Am J Obstet Gynecol 163:1049–1055PubMed
2.
Zurück zum Zitat Chames MC, Livingston JC, Ivester TS, Barton JR, Sibai BH (2002) Late postpartum eclampsia: a preventable disease? Am J Obstet Gynecol 186:1174–1177PubMedCrossRef Chames MC, Livingston JC, Ivester TS, Barton JR, Sibai BH (2002) Late postpartum eclampsia: a preventable disease? Am J Obstet Gynecol 186:1174–1177PubMedCrossRef
3.
Zurück zum Zitat Easton DJ (1998) Severe preeclampsia/eclampsia hypertensive encephalopathy of pregnancy? Cerebrovasc Dis 8:53–58PubMedCrossRef Easton DJ (1998) Severe preeclampsia/eclampsia hypertensive encephalopathy of pregnancy? Cerebrovasc Dis 8:53–58PubMedCrossRef
4.
Zurück zum Zitat Guyton AC (2006) Cerebral blood flow, cerebrospinal fluid and brain metabolism. In: Gutyton AC (ed) Textbook of medical physiology, 11th edn. Elsevier Saunders, Philadelphia, pp 761–768 Guyton AC (2006) Cerebral blood flow, cerebrospinal fluid and brain metabolism. In: Gutyton AC (ed) Textbook of medical physiology, 11th edn. Elsevier Saunders, Philadelphia, pp 761–768
5.
Zurück zum Zitat Schwartz RB, Jones KM, Kalina P, Bajakian RL, Mantello MT, Garada B et al (1992) Hypertensive encephalopathy: findings on CT, MR imaging, and SPECT imaging in 14 cases. AJR Am J Roentgenol 159:379–383PubMed Schwartz RB, Jones KM, Kalina P, Bajakian RL, Mantello MT, Garada B et al (1992) Hypertensive encephalopathy: findings on CT, MR imaging, and SPECT imaging in 14 cases. AJR Am J Roentgenol 159:379–383PubMed
6.
Zurück zum Zitat Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A et al (1996) A reversible posterior leukoencephalopathy syndrome. N Engl J Med 334:494–500PubMedCrossRef Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A et al (1996) A reversible posterior leukoencephalopathy syndrome. N Engl J Med 334:494–500PubMedCrossRef
7.
Zurück zum Zitat Servillo G, Striano P, Striano S, Tortora F, De Robertis E, Rossano F et al (2003) Posterior reversible encephalopathy syndrome (PRES) in obstetric critically ill patients. Intensive Care Med 29:2323–2326PubMedCrossRef Servillo G, Striano P, Striano S, Tortora F, De Robertis E, Rossano F et al (2003) Posterior reversible encephalopathy syndrome (PRES) in obstetric critically ill patients. Intensive Care Med 29:2323–2326PubMedCrossRef
8.
Zurück zum Zitat Antunes NL, Small TN, George D, Boulad F, Lis E (1999) Posterior leukoencephalopathy syndrome may not be reversible. Pediatr Neurol 20:241–243PubMedCrossRef Antunes NL, Small TN, George D, Boulad F, Lis E (1999) Posterior leukoencephalopathy syndrome may not be reversible. Pediatr Neurol 20:241–243PubMedCrossRef
9.
Zurück zum Zitat Roth C, Ferbert A (2011) The posterior reversible encephalopathy syndrome: what’s certain, what’s new? Pract Neurol 11:136–144PubMedCrossRef Roth C, Ferbert A (2011) The posterior reversible encephalopathy syndrome: what’s certain, what’s new? Pract Neurol 11:136–144PubMedCrossRef
10.
Zurück zum Zitat Casey SO, Sampaio RC, Michel E, Truwit CL (2000) Posterior reversible encephalopathy syndrome: utility of fluid-attenuated inversion recovery MR imaging in the detection of cortical and subcortical lesions. Am J Neuroradiol 21:1199–1206PubMed Casey SO, Sampaio RC, Michel E, Truwit CL (2000) Posterior reversible encephalopathy syndrome: utility of fluid-attenuated inversion recovery MR imaging in the detection of cortical and subcortical lesions. Am J Neuroradiol 21:1199–1206PubMed
11.
Zurück zum Zitat Loureiro R, Leite CC, Kahhale S, Freire S, Sousa B, Cardoso EF et al (2003) Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience. Am J Obstet Gynecol 189:1350–1355PubMedCrossRef Loureiro R, Leite CC, Kahhale S, Freire S, Sousa B, Cardoso EF et al (2003) Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience. Am J Obstet Gynecol 189:1350–1355PubMedCrossRef
12.
Zurück zum Zitat Bartynski WS (2008) Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol 29:1043–1049PubMedCrossRef Bartynski WS (2008) Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol 29:1043–1049PubMedCrossRef
13.
Zurück zum Zitat Mckinney AM, Short J, Truwit LC, Mckinney ZJ, Kozak OS, SantaCruz KS et al (2007) Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. Am J Radiol 189:904–912 Mckinney AM, Short J, Truwit LC, Mckinney ZJ, Kozak OS, SantaCruz KS et al (2007) Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. Am J Radiol 189:904–912
14.
Zurück zum Zitat Mueller-Mang C, Mang T, Pirker A, Klein K, Prchla C, Prayer D (2009) Posterior reversible encephalopathy syndrome: do predisposing risk factors make a difference in MRI appearance? Neuroradiology 51:373–383PubMedCrossRef Mueller-Mang C, Mang T, Pirker A, Klein K, Prchla C, Prayer D (2009) Posterior reversible encephalopathy syndrome: do predisposing risk factors make a difference in MRI appearance? Neuroradiology 51:373–383PubMedCrossRef
15.
Zurück zum Zitat Fugate JE, Claassen DO, Cloft HJ, Kallmes DF, Kozak OS, Rabinstein AA (2010) Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings. Mayo Clin Proc 85:427–432PubMedCrossRef Fugate JE, Claassen DO, Cloft HJ, Kallmes DF, Kozak OS, Rabinstein AA (2010) Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings. Mayo Clin Proc 85:427–432PubMedCrossRef
16.
Zurück zum Zitat Aukes AM, de Groot JC, Aarnoudse JG, Zeeman GG (2009) Brain lesions several years after eclampsia. Am J Obstet Gynecol 200(5):504 (e1–e5)PubMedCrossRef Aukes AM, de Groot JC, Aarnoudse JG, Zeeman GG (2009) Brain lesions several years after eclampsia. Am J Obstet Gynecol 200(5):504 (e1–e5)PubMedCrossRef
17.
Zurück zum Zitat Mattar F, Sibai BM (2000) Eclampsia. VIII. Risk factors of maternal morbidity. Am J Obstet Gynecol 182:307–312PubMedCrossRef Mattar F, Sibai BM (2000) Eclampsia. VIII. Risk factors of maternal morbidity. Am J Obstet Gynecol 182:307–312PubMedCrossRef
18.
Zurück zum Zitat Cipolla MJ (2007) Cerebrovascular function in pregnancy and eclampsia. Hypertension 50:14–24PubMedCrossRef Cipolla MJ (2007) Cerebrovascular function in pregnancy and eclampsia. Hypertension 50:14–24PubMedCrossRef
19.
Zurück zum Zitat Narbone MC, Musolino R, Granata F, Mazzù I (2006) PRES: posterior or potentially reversible encephalopathy syndrome? Neurol Sci 27:187–189PubMedCrossRef Narbone MC, Musolino R, Granata F, Mazzù I (2006) PRES: posterior or potentially reversible encephalopathy syndrome? Neurol Sci 27:187–189PubMedCrossRef
20.
Zurück zum Zitat The Magpie Trial Collaborative Group (2002) Do women with pre-eclampsia, and their babes, benefit from magnesium sulfate? The Magpie Trial: a randomised placebo-controlled trial. Lancet 359:1877–1890CrossRef The Magpie Trial Collaborative Group (2002) Do women with pre-eclampsia, and their babes, benefit from magnesium sulfate? The Magpie Trial: a randomised placebo-controlled trial. Lancet 359:1877–1890CrossRef
21.
Zurück zum Zitat Euser AG, Cipolla MJ (2009) Magnesium sulfate for the treatment of eclampsia. Stroke 40:1169–1175PubMedCrossRef Euser AG, Cipolla MJ (2009) Magnesium sulfate for the treatment of eclampsia. Stroke 40:1169–1175PubMedCrossRef
22.
Zurück zum Zitat Pollay M (1996) Blood–brain barrier, cerebral edema. In: Wilkins RH, Rengachary SS (eds) Neurosurgery, 2nd edn. Mc Graw Hill Book Co., NewYork, pp 335–344 Pollay M (1996) Blood–brain barrier, cerebral edema. In: Wilkins RH, Rengachary SS (eds) Neurosurgery, 2nd edn. Mc Graw Hill Book Co., NewYork, pp 335–344
23.
Zurück zum Zitat Donato T, Shapira Y, Artru A, Powers K (1994) Effect of mannitol on cerebrospinal fluid dynamics and brain tissue edema. Anesth Analg 78:58–66PubMedCrossRef Donato T, Shapira Y, Artru A, Powers K (1994) Effect of mannitol on cerebrospinal fluid dynamics and brain tissue edema. Anesth Analg 78:58–66PubMedCrossRef
Metadaten
Titel
Comparison of magnesium sulfate and mannitol in treatment of eclamptic women with posterior reversible encephalopathy syndrome
verfasst von
Bilge Cetinkaya Demir
Kemal Ozerkan
Sevda Erer Ozbek
Nalan Yıldırım Eryılmaz
Gokhan Ocakoglu
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2012
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-012-2268-8

Weitere Artikel der Ausgabe 2/2012

Archives of Gynecology and Obstetrics 2/2012 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.