alexa [Magnesium sulphate for the management of preeclampsia].
Reproductive Medicine

Reproductive Medicine

Gynecology & Obstetrics

Author(s): Rozenberg P

Abstract Share this page

In case of eclampsia, and especially in case of preeclampsia, no consensus exist in order to treat or to prevent convulsions by routine use of magnesium sulphate, at least in France. However, a large, multicentre, randomised trial compared the efficacy of magnesium sulphate with diazepam or phenytoin in eclamptic women. In this trial, magnesium sulphate was associated with a significantly lower rate of recurrent seizures and lower rate of maternal death than that observed with other anticonvulsants. The primary objective of magnesium sulphate prophylaxis in women with preeclampsia is to prevent or reduce the rate of eclampsia and complications associated with eclampsia. There are 3 large randomised controlled trials comparing the use of magnesium sulphate to prevent convulsions in patients with severe preeclampsia: the first one was vs phenytoin, the second vs placebo, and the third vs nimodipine. Patients receiving magnesium sulphate presented a significant lower risk of eclampsia than that observed with other comparison groups, probably by decreasing the cerebral perfusion pressure, thus avoiding a cerebral barotrauma. However, several arguments balance a wide use of magnesium sulphate: the prevalence of eclampsia in the Western world is very low, the use of magnesium sulphate does not affect the neonatal morbidity and mortality, and it is associated with a high rate of side effects, sometimes severe, such as respiratory depression. Thus, the benefit to risk ratio has to guide the use of magnesium sulphate and is directly correlated to the prevalence of eclampsia according to the risk of considered group. 1) The rate of seizures in women with mild preeclampsia not receiving magnesium sulphate is very low. Magnesium sulphate may potentially be associated with a higher number of adverse maternal effects. Therefore, the benefit to risk ratio does not support routine use of magnesium sulphate prophylaxis in this group. 2) On the other hand, the higher rate of seizures in women with severe preeclampsia (2.0%), especially in those who have imminent eclampsia, justifies prophylaxis with magnesium sulphate.

This article was published in Gynecol Obstet Fertil. and referenced in Gynecology & Obstetrics

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version