A RANDOMIZED CONTROLLED TRIAL OF INTRAVENOUS MAGNESIUM-SULFATE VERSUSPLACEBO IN THE MANAGEMENT OF WOMEN WITH SEVERE PREECLAMPSIA

Objective To determine whether the administration of prophylactic intr avenous magnesium sulphate reduces the occurrence of eclampsia in wome n with severe pre-eclampsia. Design Randomised controlled trial. Setti ng A tertiary referral obstetric unit. Population Eight hundred and tw enty-two women with severe pre-eclampsia requiring termination of preg nancy by induction of labour or caesarean section. Methods The women w ere randomised to receive either placebo (saline) or magnesium sulphat e intravenously. The investigators were blinded to the contents of the pre-mixed solutions. Main outcome measure The occurrence of eclampsia in the two groups. Results The data of 699 women were evaluated. Four teen were withdrawn after randomisation. The overall incidence of ecla mpsia was 1.8%. Of 345 women who received magnesium sulphate, one deve loped eclampsia (0.3%); in the placebo group, 11/340 women (3.2%) deve loped eclampsia (relative risk 0.09; 95% confidence interval 0.01-0.69 ; P = 0.003). Conclusion The use of intravenous magnesium sulphate in the management of women with severe preeclampsia significantly reduced the development of eclampsia.