Doctors who dismissed as an old wives' remedy the use of magnesium to treat pregnant women with eclampsia may have to think again.
Scientists from the Radcliffe Infirmary in Oxford, England have proved that the supplement is far less expensive, and is more effective, than drug alternatives such as diazepam and phenytoin.
Eclampsia is a disorder which occurs in 1 in 2000 deliveries in developed countries and causes a series of convulsions in the woman; it accounts for about 50,000 maternal deaths a year, although mainly in Third World countries.
Scientists fear that many women have died needlessly because doctors have preferred a drug-based remedy, even though there has been no scientific evidence to prove it is more beneficial than magnesium. From 1906, when magnesium was first suggested as a treatment for eclampsia, to 1987, when phenytoin was introduced, about four million women have died from the condition. Some of those could have been saved if doctors had relied on science, rather than dogma.
One research group had described the use of magnesium sulphate as "more a matter of habit, if not religious conviction, than a scientifically established treatment."
Arguments about the various anticonvulsants to use have been vociferous, if not vitriolic, the Radcliffe researchers report. Although magnesium treatment was first suggested nine years ago, and has been a popular treatment in the US for the past 60 years, only 2 per cent of British obstetricians have used it, preferring drug remedies.
The Radcliffe study, called the Collaborative Eclampsia Trial, looked at the records of 1,680 women treated for eclampsia; 453 were given magnesium, 452 had diazepam and 387 were prescribed phenytoin. The women given magnesium had a 52 per cent lower risk of recurrent convulsions than those given diazepam and phenytoin.
The women on magnesium were also less likely to develop pneumonia and to be admitted to intensive care, than those on phenytoin. Babies born of the magnesium group were also significantly less likely to be intubated where a breathing tube is inserted and to be admitted to a special care nursery.
Researchers also feel that magnesium should be given as a "just-in-case" remedy for women suffering pre-eclampsia, before the first fit occurs (The Lancet, June 10, 1995).