Definitive trial signals triumph for researchers in the developing world

Until this year, the pharmacological treatment of eclampsia has been determined largely by geography, habit, and prejudice. Magnesium sulphate has been the drug of choice in the United States; in Britain, diazepam and, more recently, phenytoin have been favoured.1 None of these choices was influenced by strong scientific evidence.

A network of researchers has recently reported the first large randomised trial comparing these three drugs in eclampsia.2 The collaborative eclampsia trial is the most important obstetric trial of the 20th century, and it has set new standards for vision and ambition in clinical trials in perinatal medicine. It included no fewer than 1680 eclamptic women recruited by local clinicians in west and southern Africa, South America, and India; and the trial was coordinated mainly by the National Perinatal …