Efficacy of Prophylactic Intravenous Magnesium Sulfate Tapering versus Continuous Infusion for Eclampsia Prevention in Severe Preeclampsia

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 555–566

DOI: 10.46882/2026/IJOG/000527

Original Research Article

Title: Efficacy of Prophylactic Intravenous Magnesium Sulfate Tapering versus Continuous Infusion for Eclampsia Prevention in Severe Preeclampsia

Names of Authors: Ibrahim K. Sanusi¹, Chioma J. Nwachukwu¹

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Abstract:
Standard continuous 24-hour postpartum infusions of magnesium sulfate (MgSO₄) can contribute to maternal drug toxicity, motor weakness, and high nursing care burdens. This randomized controlled non-inferiority trial evaluated whether a shortened, prophylactic 12-hour intravenous MgSO₄ tapering regimen offers equivalent protection against eclamptic seizures compared to the traditional 24-hour continuous protocol in women with severe preeclampsia. Two hundred and sixty parturients diagnosed with severe preeclampsia were randomized to either the abbreviated 12-hour tapering group (n = 130) or the standard 24-hour group (n = 130) following a uniform 4 g loading dose. The primary endpoint was the development of eclamptic convulsions within 48 hours postpartum. No cases of eclampsia occurred in either the 12-hour or the 24-hour cohort (0.0% vs. 0.0%, p = 1.00), satisfying the pre-specified non-inferiority margin. Signs of mild magnesium toxicity, such as absent deep tendon reflexes or respiratory depression, were significantly lower in the abbreviated tapering arm (1.5% vs. 7.7%, p = 0.018). Furthermore, the mean time to unassisted maternal mobilization was significantly shorter in the 12-hour group (14.2 ± 2.4 hours vs. 26.5 ± 4.2 hours, p < 0.001), accelerating transition to newborn care. A shortened 12-hour postpartum magnesium sulfate tapering regimen is non-inferior to the standard 24-hour continuous infusion for eclampsia prevention in severe preeclampsia while significantly minimizing drug toxicity risks and improving early maternal recovery timelines.

Keywords: Severe Preeclampsia; Magnesium Sulfate; Eclampsia Prevention; Drug Toxicity; Postpartum Care; Shortened Regimen.

Manuscript Timeline: Received: June 12, 2026; Revised: July 30, 2026; Accepted: August 10, 2026; Published: August 31, 2026.

Citation: Sanusi IK, Nwachukwu CJ. Efficacy of Prophylactic Intravenous Magnesium Sulfate Tapering versus Continuous Infusion for Eclampsia Prevention in Severe Preeclampsia. International Journal of Obstetrics and Gynecology. 2026; 14(8): 555–566.

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