05/30/2002 By Harvey McConnell
A landmark study among 10,141 pregnant women with pre-eclampsia in 33 countries finds magnesium sulphate reduces by more than 50 percent their chances of developing eclampsia. Clinicians said that the striking findings and low cost of magnesium sulphate ($5 per patient) could result in a significant change in the clinical management of pre-eclampsia worldwide. Because of the conclusive evidence, the Magnesium Sulphate for Prevention of Eclampsia (MAGPIE) trial was stopped early.
The intervention had an overall 58 percent reduction in risk compared with placebo.
The study, directed by Dr Lelia Duley, Resource Centre for Randomised Trials, Institute of Health Sciences, Oxford, England, is the largest trial ever conducted for the hypertensive disorders of pregnancy. It is 12 times larger than any previous trial of magnesium sulphate versus placebo, and took 3.5 years to complete recruitment. An estimated 8 percent of pregnant women develop pre-eclampsia.
Eclampsia is more common in less-developed countries, and causes some 50,000 maternal deaths a year worldwide.
Anticonvulsants are used for pre-eclampsia in the belief they prevent eclamptic convulsions. Research in the United States, where it was first used in obstetrics almost a century ago suggested that the anticonvulsant magnesium sulphate offers the best hope for reducing the development of eclampsia among women with pre-eclampsia. However, no adequate trials
have been done prior to the MAGPIE trial.
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