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Magnesium sulphate versus lytic cocktail for eclampsiaDuley L, Gülmezoglu AM
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SummaryMagnesium sulphate versus lytic cocktail for eclampsiaMagnesium sulphate is more effective than lytic cocktail in preventing further fits for pregnant women with eclampsia. Eclampsia is when a pregnant woman with pre-eclampsia has one or more convulsions (fits). Pre-eclampsia, also known as toxaemia, is a condition which leads to high blood pressure and protein in the urine. Eclampsia is a serious threat to the life of both mother and baby. Although the trials were small and of average quality, the review found that magnesium sulphate is better than lytic cocktail at preventing further fits, breathing problems and, possibly, deaths. Magnesium sulphate is also cheap and easy to use.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
January 22. 2001 AbstractBackgroundEclampsia, the occurrence of a seizure in association with pre-eclampsia, is a rare but serious complication of pregnancy. A number of different anticonvulsants are used to control eclamptic fits and to prevent further seizures. ObjectivesThe aim of this review was to compare the effects of magnesium sulphate with those of lytic cocktail when used for the care of women with eclampsia. Search strategyThe register of trials held by the Cochrane Pregnancy and Childbirth Group was searched for relevant trials. The Cochrane Controlled Trials Register in The Cochrane Library Issue 2, 2000 was also searched. Selection criteriaRandomised trials recruiting women with eclampsia, and comparing any use of magnesium sulphate with any use of lytic cocktail. Data collection and analysisData were extracted from each report without any blinding of the results or of the treatments which women received. Main resultsTwo trials with 199 women were included in the review. These were both small and of average quality. Magnesium sulphate was better than lytic cocktail at preventing further fits (relative risk (RR) 0.09, 95% confidence interval (CI) 0.03-0.24; risk difference (RD) 0.43, 95% CI -0.53, -0.34; number needed to treat (NNT) 3, 95% CI 2-3) and was associated with less respiratory depression (RR 0.12, 95% CI 0.02-0.91). Magnesium sulphate was also associated with fewer maternal deaths than lytic cocktail, but the difference was not statistically significant (RR 0.25, 95% CI 0.04-1.43). Authors' conclusionsMagnesium sulphate is the anticonvulsant of choice for women with eclampsia. Lytic cocktail should be abandoned. |