THURSDAY, May 30, 2002 (HealthDayNews) -- A major international study shows that magnesium sulfate, an inexpensive, easily administered drug, can prevent eclampsia, a life-threatening, pregnancy-related condition.
In the study, which recruited more than 10,000 pregnant women in 33 countries, the incidence of eclampsia was halved in those who were given magnesium sulfate when the early signs of the condition appeared, says a report in the June 1 issue of The Lancet. The trial was ended early when the ongoing results showed a 45 percent decrease in maternal deaths for women given the drug, compared to those who got a placebo, an inactive substance.
All the women in the trial were diagnosed with preeclampsia, whose major symptoms are high blood pressure, protein in the urine and edema, an abnormal buildup of body fluid. Preeclampsia occurs in up to 8 percent of pregnancies worldwide. Untreated, it can lead to the violent convulsions of eclampsia, which is responsible for about one fourth of all pregnancy-related deaths.
An international trial in 1995 showed that early treatment with magnesium sulfate could prevent deaths when eclampsia developed. That trial has been called "one of the most important obstetric randomized trials of the century," says Sir Iain Chalmers, founding director of the U.K. Cochrane Centre, a part of Britain's National Health Service, who is co-author of an editorial in the journal.
"Although the earlier trial was done entirely in developing countries, it transformed practice in this country," Chalmers says. "In Britain, there were many obstetricians who were not using this extremely cheap drug in women who were having fits during pregnancy. It gave British obstetricians information on how they should treat eclampsia."
"Now this study provides evidence that has been needed to convince obstetricians that magnesium sulfate is the way to prevent eclampsia," he adds.
Magnesium sulfate has been an accepted treatment in the United States for years, says Dr. Gerda Zeeman, a spokeswoman for the American College of Obstetrics and Gynecology. "It is very good at both preventing and controlling eclampsia," Zeeman, an assistant instructor in obstetrics and gynecology at the University of Texas Southwestern Medical Center, adds.
Treatment depends on when the symptoms of preeclampsia are detected, she says.
"If the woman is 38 weeks or more into the pregnancy, the baby will be delivered early," she says. "If it is earlier in the pregnancy, the treatment will be bed rest and careful observation. Magnesium sulfate will be used when women with preeclampsia are undergoing induction of labor, and also if they have a seizure."
The use of magnesium sulfate is especially important in developing countries, Chalmers says in the editorial. "It is now up to those responsible for maternal health services -- at local, national and international levels -- to ensure that this effective, apparently safe and inexpensive drug is available to women everywhere when needed," he writes.
Worldwide, the World Health Organization estimates, eclampsia accounts for 50,000 maternal deaths each year.
What To Do
For detailed information about eclampsia and its precursor, turn to the National Library of Medicine or the Preeclampsia Foundation.
