Magnesium sulphate and pre-eclampsiaBMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7201.3 (Published 03 July 1999) Cite this as: BMJ 1999;319:3
Trial needed to see whether it's as valuable in pre-eclampsia as in eclampsia
- Lelia Duley, Obstetric epidemiologist,
- James P Neilson, Professor of obstetrics and gynaecology
- Magpie Trial Coordinating Centre, Institute of Health Sciences, Oxford OX3 7LF
- University of Liverpool, PO Box 147, Liverpool L69 3BX
Magnesium sulphate has been used for treating eclampsia in the United States for much of the 20th century.1 The international collaborative eclampsia trial confirmed that this anticonvulsant is indeed more effective, and safer, than alternative drugs.2 British obstetric practice has changed rapidly in response to these findings,3 and standard treatment of eclampsia in the United Kingdom now much more closely corresponds to that of the United States, although some controversies remain about optimal dosage.
Is treatment of pre-eclampsia also better in the United States? As many as 5% of all pregnant women in some US centres receive magnesium sulphate in the belief that this prevents eclampsia and thus improves the outcome of pregnancy.4 In contrast, some UK experts advocate never using anticonvulsants for pre-eclampsia5; many clinicians would use anticonvulsants only in women …