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Int J Gynaecol Obstet. 2012 Aug;118(2):90-6. doi: 10.1016/j.ijgo.2012.01.028. Epub 2012 Jun 15.

A systematic review of maternal and infant outcomes following magnesium sulfate for pre-eclampsia/eclampsia in real-world use.

Author information

1
Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada. mcdonals@mcmaster.ca

Abstract

BACKGROUND:

Evidence from RCTs shows that magnesium sulfate reduces the risk of seizures and mortality for women with pre-eclampsia/eclampsia. However, it has been argued that outcomes within trials may not reflect real-world outcomes with the same intervention.

OBJECTIVE:

To assess whether outcomes for women with pre-eclampsia/eclampsia who received magnesium sulfate in the real world were comparable to those in RCTs.

SEARCH STRATEGY:

EMBASE and MEDLINE were searched (January 1990-July 2010).

SELECTION CRITERIA:

Cohort, before-and-after, and serial cross-sectional studies were included. Participants were women with eclampsia who received magnesium sulfate or another anticonvulsant, and women with pre-eclampsia who received magnesium sulfate or no anticonvulsant. Primary outcomes were death (maternal, fetal, neonatal) or recurrent seizures.

DATA COLLECTION AND ANALYSIS:

Data were extracted independently by 2 reviewers.

MAIN RESULTS:

Six studies (1831 women with eclampsia) were included, from academic centers in Bangladesh, India, Pakistan, and Nigeria, together with 2 population-based UK studies. Magnesium sulfate for eclampsia was associated with lower risks of maternal death, recurrent seizure, and major morbidity; for pre-eclampsia, it was associated with lower risks of eclampsia.

CONCLUSION:

Improvements in maternal outcome with magnesium sulfate for pre-eclampsia/eclampsia in real-world use are comparable to those reported in RCTs.

PMID:
22703834
DOI:
10.1016/j.ijgo.2012.01.028
[Indexed for MEDLINE]

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