Post Magpie: how should we be managing severe preeclampsia?

Preeclampsia is a common complication of pregnancy and a significant cause of fetal and maternal morbidity and mortality. The purpose of this review is to highlight and discuss aspects of some of the more recent clinical management papers published in the field of preeclampsia and eclampsia. The title explains the clinical nature of this paper and a detailed review of the basic science literature is beyond the scope of this article.

Several controversial areas still exist in the current management of severe preeclampsia/eclampsia. We present a number of interesting papers dealing with practical management questions and discuss the optimum treatment regimen for preventing eclampsia. The findings of the MAGPIE study are discussed. Opinions are expressed as to the current management of preterm severe preeclampsia, and we outline a new hypothesis on the etiology of eclampsia.

Preeclampsia/eclampsia remains a disease without a clear etiology. Despite this, clinical management issues are being addressed and maternal morbidity and mortality continue to fall.