Audit can ensure the safe and effective introduction of seizure prophylaxis with magnesium sulphate in obstetric practice.

Objective: To audit the effectiveness and safety of intravenous magnesium sulphate therapy in severe pre-eclampsia.

Design: A complete audit cycle including the first eight cases receiving therapy, an intervention with staff instruction and the re-audit of eight further consecutive cases. The issues for audit were compliance with the protocol and the achievement and maintenance of therapeutic magnesium concentrations.

Setting: Labour room, Glasgow Royal Maternity Hospital.

Subjects: Women with severe pre-eclampsia fulfilling pre-determined criteria for seizure prophylaxis with intravenous magnesium therapy.

Results: Protocol violations resulted both in delays in achieving therapeutic magnesium concentrations and high magnesium concentrations in five of the eight initial cases. Following circulation of the results and staff education, the re-audit demonstrated near complete compliance with the protocol and a more consistent interval to achieving a therapeutic magnesium concentration. There were no cases of eclampsia or magnesium toxicity amongst women delivering at GRMH during the period of this audit.

Conclusion: This audit has demonstrated that seizure prophylaxis with intravenous magnesium sulphate can be safely and effectively introduced to the obstetric management of women with severe pre-eclampsia.