Abstract
Eclampsia is a common complication of preeclampsia patients and can be life-threatening for both the mother and the fetus. Hence, timely intervention and appropriate management of this detrimental condition are extremely crucial. Eclampsia is described as the occurrence of generalized convulsions in patients with preeclampsia. Magnesium sulfate (MgSO4) is the drug of choice for treating and preventing eclampsia. This review aims to study and analyze the available literature on the pathogenesis of eclampsia, the pharmacology of MgSO4, and its effectiveness in the management of eclampsia. Other proposed treatments and their comparative study with MgSO4 are also discussed. Additionally, we examine the data regarding the impact of eclampsia, its public health burden, and the cost-effectiveness of MgSO4. One of the major drawbacks associated with the use of MgSO4 in low-income countries has been the cost of treatment and the lack of resources. We have analyzed the trials that have proposed alternate treatment regimens which could shape new guidelines to resolve these issues. For this review, we extensively studied abstract and full-text articles from multiple databases. This article discusses the pathophysiology of eclampsia, the pharmacology of MgSO4, the issues surrounding eclampsia management, and how MgSO4 benefits these patients.
Highlights
BackgroundEclampsia is a known deleterious sequela of preeclampsia
Simon et al of the MAGPIE trial stated that MgSO4 is most cost-effective when it is limited to patients with severe preeclampsia, which is the precursor to eclampsia
MgSO4 reduces the incidence of eclampsia and lowers maternal mortality, and should be considered for women with preeclampsia who are at risk of developing eclampsia
Summary
Eclampsia is a known deleterious sequela of preeclampsia. It has been defined as new-onset generalized tonic-clonic seizures in patients with preeclampsia. Even with the risk of side effects and toxicity, many studies have proven that MgSO4 is much more superior in the treatment of eclampsia compared to other drugs [4,5]. The study proved that the use of MgSO4 reduces the risk of developing eclampsia by 50% and lowers the maternal mortality rate Since this landmark trial, the WHO has promoted the use of MgSO4 for seizure prophylaxis [37]. Simon et al of the MAGPIE trial stated that MgSO4 is most cost-effective when it is limited to patients with severe preeclampsia, which is the precursor to eclampsia This trial stated that to prevent one case of eclampsia, the cost in USD for 2001 was $21,202 in high, $2,473 in middle, and $456 in low-income countries. The following inclusion criteria were used and decided upon based on the authors’ discretion: women without eclampsia; women with preeclampsia; primary objectives including the development of eclampsia, other lifethreatening complications, or death; treatment group receiving MgSO4 as per the local regimen; and a sample size of >100
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