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Magnesium sulphate versus diazepam for eclampsia.

L Duley¹, D Henderson-Smart

¹Resource Centre for Randomised Trials, Institute of Health Sciences, Old Road, Headington, Oxford, UK, OX3 7LF. lelia.duley@ndm.ox.ac.uk

The Cochrane Database of Systematic Reviews

|October 30, 2003

Summary

Magnesium sulfate significantly reduces maternal deaths and recurrent seizures in women with eclampsia compared to diazepam. This anticonvulsant also improves infant outcomes, including Apgar scores and special care unit stays.

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Area of Science:

Obstetrics and Gynecology
Neurology
Pharmacology

Background:

Eclampsia is a rare but severe pregnancy complication characterized by seizures.
Anticonvulsants are crucial for managing eclamptic seizures and preventing recurrence.

Purpose of the Study:

To compare the efficacy and safety of magnesium sulfate versus diazepam in treating eclampsia.
To evaluate the impact on maternal mortality, seizure recurrence, and neonatal outcomes.

Main Methods:

Systematic review of randomized controlled trials.
Searched Cochrane Pregnancy and Childbirth trials register and Cochrane Central Register of Controlled Trials.
Included trials comparing magnesium sulfate (IV/IM) with diazepam for diagnosed eclampsia.

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Main Results:

Magnesium sulfate reduced maternal death by 41% (RR 0.59, 95% CI 0.37-0.94) and recurrent seizures by 56% (RR 0.44, 95% CI 0.34-0.57).
Fewer infants had Apgar scores below seven (RR 0.72, 95% CI 0.55-0.94) and shorter special care unit stays with magnesium sulfate.
Seven trials involving 1441 women were included, with most data from high-quality trials.

Conclusions:

Magnesium sulfate demonstrates superior effectiveness compared to diazepam for eclampsia treatment.
The findings support magnesium sulfate as a primary anticonvulsant therapy for eclampsia.