May 30, 2002 -- An inexpensive, readily available drug may be able to save the lives of tens of thousands of women who die each year during childbirth as a result of eclampsia, or toxemia of pregnancy. A major new study shows the drug -- magnesium sulfate -- can cut in half a woman's risk of developing potentially fatal seizures.
As many as 8% of all pregnant women suffer from pre-eclampsia, a pregnancy-induced form of severe high blood pressure that can lead to eclampsia, which causes potentially fatal convulsions. Researchers estimate that approximately one-fourth of all deaths directly caused by pregnancy-related complications are due to pre-eclampsia and eclampsia.
Although the conditions are relatively rare in developed countries, affecting about one in 2,000 deliveries, they are a much bigger public health threat in developing countries where frequency ranges from one in 100 to one in 1,700 births.
Antiseizure drugs have been given to women with pre-eclampsia for decades in order to reduce the risk of seizures or even death, but there has been little scientific evidence to back this practice.
One study published seven years ago -- based on the experience of 1,687 women in nine developing countries -- showed that magnesium sulfate was the most effective antiseizure drug for controlling seizures due to eclampsia, but use of the drug continues to vary greatly worldwide.
Now a new study, published in the June 1 issue of The Lancet, is the largest ever on the subject -- involving more than 10,000 pregnant women with pre-eclampsia.
Researchers found that women who received magnesium sulfate had a 58% lower risk of eclampsia. The drug also reduced the risk of the women dying during childbirth and seemed to work without any significant side effects to mother or child.
In a commentary accompanying the study, Shirish S. Sheth and Iain Chalmers of the 2/2 Navjivan Society in India and the U.K. Cochrane Centre say this study proves that magnesium sulfate is both effective and safe for controlling pre-eclampsia and preventing eclampsia.
"In theory, hundreds of thousands of women could benefit from the evidence yielded by [this and the previous study]," write the editorialists.