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Magnesium sulphate versus lytic cocktail for eclampsia
Lelia Duley1, A Metin Gülmezoglu, Doris Chou
1Centre for Epidemiology and Biostatistics, University of Leeds, Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, West Yorkshire, UK, BD9 6RJ.
The Cochrane Database of Systematic Reviews
|September 9, 2010
Summary
Magnesium sulfate significantly reduces maternal deaths and prevents further seizures in women with eclampsia compared to lytic cocktail. This anticonvulsant is the preferred treatment, showing better outcomes and less serious maternal morbidity.
Area of Science:
- Obstetrics and Gynecology
- Neurology
- Pharmacology
Background:
- Eclampsia, characterized by seizures in pre-eclampsia, is a severe pregnancy complication.
- Various anticonvulsants are employed to manage eclamptic seizures and prevent recurrence.
Purpose of the Study:
- To compare the efficacy and safety of magnesium sulfate versus lytic cocktail for eclampsia management.
- To evaluate magnesium sulfate's effects against diazepam and phenytoin in separate reviews.
Main Methods:
- Systematic review of randomized controlled trials identified through Cochrane databases up to July 2010.
- Included trials compared intravenous or intramuscular magnesium sulfate with lytic cocktail in women diagnosed with eclampsia.
- Trial quality was assessed and data extracted by two independent reviewers.
Main Results:
- Magnesium sulfate use was linked to a significant reduction in maternal deaths (RR 0.14) and fewer recurrent seizures (RR 0.06) compared to lytic cocktail.
- It also decreased rates of respiratory depression (RR 0.12), coma (RR 0.04), and pneumonia (RR 0.20).
- No significant difference was observed in infant mortality rates between the two treatments.
Conclusions:
- Magnesium sulfate is superior to lytic cocktail in reducing maternal mortality, seizure recurrence, and severe maternal morbidity in eclampsia.
- Magnesium sulfate is recommended as the first-line anticonvulsant treatment for eclampsia.
- The use of lytic cocktail for eclampsia should be discontinued.
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