Table 2

Summary of findings on whether clinicians should use magnesium sulphate to prevent eclampsia: resource use viewed from the perspective of the health system

Resource Cost*Typical absolute effect (95% CI)No of participants (studies)Quality of evidenceComment
Magnesium sulphate ampoules (6×10 ml ampoules/patient)
Setting:
 High income countries$20 more/patient9996High†
 Middle income countries $3 more/patient
 Low income countries$5 more/patient
Administration of magnesium sulphate (1 ampoule/patient)
Setting:
 High income countries$66/patient9996High†Resources for giving magnesium sulphate included midwives’ time (main cost), intravenous cannula or needles, syringes, intravenous fluids, and the drug
 Middle income countries $14/patient
 Low income countries $8/patient
Other hospital resources (varied widely)
Setting:
 High income countries$12 839$20 less/ patient ($0 to $60)9.996Moderate‡Use of other hospital resources varied greatly in both intervention and control groups. Other hospital costs have been adjusted for on the basis of the influence of eclampsia to control for the many other factors that influenced these costs
 Middle income countries $1 416$4 less/ patient ($0 to $10)
 Low income countries $157$2 less/ patient ($1 to $3)

*$1=£0.5=€0.7.

†Evidence comes from randomised trials and there was no reason to grade down for study limitations, imprecision, inconsistency, indirectness, or publication bias.

‡The confidence interval was wide so the evidence was graded down for imprecision.