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Magnesium sulphate versus phenytoin for eclampsia
Lelia Duley1, David J Henderson-Smart, 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
|October 8, 2010
Summary
Magnesium sulfate significantly reduces seizure recurrence in women with eclampsia compared to phenytoin. This anticonvulsant also improves maternal and infant outcomes, making it the preferred treatment.
Area of Science:
- Obstetrics and Gynecology
- Neurology
- Pharmacology
Background:
- Eclampsia, a severe pregnancy complication involving seizures, necessitates effective anticonvulsant therapy.
- 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 phenytoin in treating women diagnosed with eclampsia.
Main Methods:
- Systematic review of randomized controlled trials identified through the Cochrane Pregnancy and Childbirth Group's Trials Register.
- Inclusion criteria focused on trials comparing magnesium sulfate with phenytoin for eclampsia treatment.
- Trial quality assessment and data extraction were performed by two independent reviewers.
Main Results:
- Magnesium sulfate demonstrated a significant reduction in seizure recurrence compared to phenytoin (RR 0.34, 95% CI 0.24 to 0.49).
- Trends favored magnesium sulfate for maternal mortality, reduced pneumonia risk, ventilation needs, and ICU admissions.
- Infant outcomes improved with magnesium sulfate, showing fewer special care baby unit admissions and reduced mortality or prolonged SCBU stays.
Conclusions:
- Magnesium sulfate is superior to phenytoin in managing eclampsia, significantly lowering seizure recurrence.
- The drug also shows benefits for maternal and infant outcomes, establishing it as the first-line treatment.
- Clinical practice should prioritize magnesium sulfate and discontinue the use of phenytoin for eclampsia.
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