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

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.