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Magnesium may halve the risk of eclampsia

A new, landmark study has shown that pregnant women with preeclampsia treated with magnesium sulphate can halve the risk of eclampsia (convulsions) and maternal death.

In this randomised study dubbed the Magpie Trial (Magnesium Sulphate for Prevention of Eclampsia), 10,141 preeclamptic women from 33 countries received magnesium sulphate or placebo intravenously (iv) or intramuscularly (im).

When it became clear that magnesium overwhelmingly reduced the risk of eclampsia by 58 per cent and maternal death by 45 per cent vs placebo, the investigators called an early halt to the trial.

Adverse effects, though tolerable, were reported in 24 per cent of women given magnesium vs 5 per cent of those given placebo, and were less common with iv administration.

However, questions still remain as to the minimum effective dose, optimal time to give it, and long-term consequences of exposure for mother and infant (Lancet, 2002; 359: 1877-90, 1872-3).

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