Drug cuts risk of seizures in pregnancy

New data from a massive international research effort indicate that an inexpensive drug treatment lessens the risk of seizures that sometimes strike and even kill women during pregnancy or immediately after delivery. The finding could stimulate efforts to make the anticonvulsant drug, magnesium sulfate more widely available and more routinely used.

Worldwide, an estimated 50,000 pregnant women die each year from complications related to preeclampsia, a condition of elevated blood pressure and protein buildup in urine that develops during some pregnancies. This occasionally results in eclampsia, including seizures that can be lethal.

In some countries including the United States, anticonvulsants have long been prescribed to preeclamptic women. A dearth of data on various drugs’ effectiveness, however, has given rise to inconsistent and spotty treatment.

To test the effectiveness of magnesium sulfate, the Magpie Trial Collaborative Group, a research team of scientific and medical personnel from 175 hospitals in 33 countries, studied 10,141 women with preeclampsia. Half the women received magnesium sulfate by injection or infusion in the hospital over about 24 hours, and the rest got a placebo.

While 96 placebo takers developed eclampsia and 20 of them died, just 40 women receiving the drug experienced eclamptic seizures and just 11 of these died, the researchers report in the June 1 Lancet. The rate of survival among the women’s babies was unaffected.

The new study “strengthens beyond reasonable doubt” the evidence that magnesium sulfate reduces the risk of eclampsia among preeclamptic women, conclude Shirish S. Sheth of the Navjivan Society in Mumbai, India, and Iain Chalmers of the U.K. Cochrane Centre in Oxford, England, in a commentary published with the study. They argue that the finding places a burden of responsibility on international organizations to make magnesium sulfate generally available in poor countries.

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