Epsom salts prevent convulsions in pregnancy

Many pregnant women with such symptoms as swollen faces, hands and feet may not realise these are indicative of pre-eclampsia, a condition that leads to convulsion. However, a cheap solution to prevent this according to Sade Oguntola, is Epsom salts.

MRS. Joke Adeyeye sat on a tall chair holding a four-month-old baby. She recollected how her baby boy was born at a hospital near her home. She told her friend: “I was doing well and felt wonderful during my seventh month of pregnancy. At that time, I went to the doctor for a check-up, and he informed me that my blood pressure was normal and that I was doing fine. In addition, I only weighed 60 kilogrammes at that time. Just before leaving the office, I said that I had recently begun to get headaches, which was a new experience for me.

“After several weeks, I started getting sick and hungry. I began to ex-perience swollen in my ankles. It was then that the doctor ordered daily diuretics, or water pills, and visits to his office three times a week for a fluid shot.

“He also cautioned that I reduced salt intake and always made sure my legs were always raised to ensure that body fluid does not accumulate in my limbs." Mrs. Adeyeye is one of the several women that have symptoms that could be warning signs of fatal condition for pregnant women and their babies. The condition is called pre-eclampsia. If untreated, it can lead to life-threatening eclampsia, in which a woman suffers seizures or may even go into a coma.

The signs of trouble are subtle at first, and many women might miss them, especially if it is their first pregnancy: swelling in the face, hands and feet, severe headaches, flashes of light or other vision problems.

Doctors in Nigeria, where the majority of women get regular prenatal care, would recognise the swelling and headaches as signs that a woman’s blood pressure was rapidly increasing and would begin treatment. Most likely, the woman and her baby would be fine.

“Pre-eclampsia is a common problem in pregnancy,” Prof. Dosu Ojendegbe, an obstetrist and gyneacologist at the University College Hospital (UCH), Ibadan, said. “If it progresses to full-blown eclampsia, the mother can have convulsions which would endanger her life and the unborn child's.”

This pregnancy complication which affects eight in every 100 pregnant women, Prof. Ojendegbe said, is characterised by high blood pressure, protein in the urine and multi-organ dysfunction. “When it is severe and occurs early in the pregnancy, delivery to protect the mother results in a premature baby,” he said.

The World Health Organization (WHO) said that about 63,000 women die every year of eclampsia and severe preeclampsia. A baby is also at risk if the mother dies before the baby is able to survive outside the womb. About 300,000 newborns either die or are disabled each year by complications from pre-eclampsia or eclampsia.

Although pre-eclampsia was discovered 150 years ago, doctors have not known why some women develop it and others do not. Researchers from the University of Pittsburgh School of the Health Sciences reported in the Journal of Clinical Endocrinology and Metabolism, said that Vitamin D deficiency early in pregnancy is associated with a five-fold increased risk of pre-eclampsia.

Other researchers said that genes from both the mother and father could trigger pre-eclampsia in a study published online by the British Medical Journal. Researchers in Norway found that daughters of women who had pre-eclampsia during pregnancy had more than twice the risk of pre-eclampsia themselves compared with other women. Men born after a pregnancy complicated by pre-eclampsia also had a moderately increased risk of fathering a pre-eclamptic pregnancy.

Currently, doctors measure expectant mothers’ blood pressure and protein levels in the urine in a bid to detect the disease. However, this does not spot the problem in all sufferers. Prof. Ojendegbe said that being able to predict the onset of this disease has been the single greatest challenge in obstetric medicine, yet, research has shown that Magnesium Sulphate injections, the same as those found in Epsom salts can prevent those convulsions.

When women with pre-eclampsia were given an injection of magnesium sulphate, it halved the risk of eclampsia. The three-year £2.5 million “Magpie” study conducted in 33 countries involving 10,141 women showed beyond “reasonable doubt” that intravenous magnesium reduces the risk of pre-eclampsia progressing to eclampsia among women with pre-eclampsia. The relative risk of eclampsia was reduced by 58 per cent and the mortality rate nearly cut in half among women receiving magnesium compared to those who received a saline drip.

Prof. Ojendegbe said that though the use of magnesium sulphate is safe, effective and cheap, it is however very expensive in Nigeria and so many people cannot afford it. “We tried to manufacture it once and even now a drug company has it at a cheap rate, but we still need a strategy to ensure its routine use and that it is made available at every nook and cranny of the country. Also, there is the need for training to ensure it is properly used.

“When this is combined with the introduction of an anti-shock garment that has been proven as effective to help save dying people from loss of blood, including that from childbirth after delivery, we can actually achieve a reduction in the high death rate among women due to pregnancy and other related problems. “Both bleeding which could be of several causes such as from ectopic pregnancy and eclampsia probably accounts for up to 65 per cent of causes of maternal mortality,” Prof. Ojendegbe said.

In some countries, magnesium sulphate is not licensed for sale; in others it is not on a list of “essential drugs,” medications that WHO defines as necessary for basic public health according to Dr. Joseph Ruminjo, Senior Clinical Manager for the Safe Motherhood programme at Engender Health, thus explaining some of the dilemma of ensuring women are protected from dying from eclampsia with Epson salt.

Dr. Edward Jagun, a consultant Obstetrician and gynecologist with Olabisi Onabanjo University Teaching Hospital, Sagamu said magnesium sulphate is very good and protective against eclampsia. He said due to its high cost and unavailability, “what some people do now is to boil water very well to sterilise it and then add the Epsom salt that is very available and then give in form of injection into the muscles.”

This crude method, Dr. Jagun said is not a normal practice and the result could not be as effective as having the form of sterilised magnesium sulphate that was used in the Magpie study, even though this had helped to save some patients life. This is one thing the government should take up its production as a way of reducing its cost and ensuring it is within the reach of every individual that needs it to reduce the incidence of the eclampsia, the third most common reason women die from pregnancy in this country.