A Systematic Review on the Effect of Magnesium Sulphate Prophylaxis in Pregnant Mothers Diagnosed With Preeclampsia

Abstract

Background- Most studies agree on the effect of magnesium sulphate in treating eclampsia or controlling convulsion/seizure in pregnancy but controversies still remained on the importance of magnesium sulphate prophylaxis in preeclampsia to prevent eclampsia and other adverse birth outcomes.

Aim- The aim of this review was to assess the effect of magnesium sulphate prophylaxis on preeclamptic mothers in light of disease progression and adverse outcomes.

Methods- A comprehensive computer-based search of the published work was done in, PubMed/MEDLINE, HINARI and Google scholar. Studies that assessed the effect of magnesium sulphate on prevention of eclampsia and maternal and perinatal birth outcomes and published only in English language were included. Studies that reported progression of preeclampsia to eclampsia and the effect of magnesium sulphate on birth outcomes were included. Statistical analyses were performed using Review Manager, version 5.3 (The Cochrane Collaboration) and STATA Version 11. Quantitative data were presented as risk ratios (RR) with 95% confidence intervals (CI) and  pooled estimates (summary RR with 95% CI) were calculated using random-effect meta-analysis.

Results- Overall, 28002 mothers with preeclampsia were included and the individual studies were conducted in American, Asian, European and African countries. About 58% of the studies were randomized control trials. Mild preeclamptic mothers who took magnesium sulphate have similar risk of developing eclampsia as compared with the no magnesium sulphate counterparts (RR: 0.9, 95% CI: 0.53-1.54)). On the contrary, severe preeclamptic mothers who took magnesium sulphate have 66% lower risk of developing eclampsia as compared with the no magnesium sulphate counterparts (RR: 0.34, 95% CI:0.23-0.48)).

Conclusion- From this systematic review and meta-analysis it can be concluded that magnesium sulphate prophylaxis provision for mild preeclampsia cases has no value in preventing severe preecalampsia but found to be effective in preventing eclampsia/convulsion in sever preeclampsia cases.  It is recommended that magnesium sulphate should not be given to mild and moderate preeclampsia cases in the absence of adequate evidence from randomized controlled trials.

Keywords: magnesium sulphate, preeclampsia/eclampsia, convulsion