Magnesium sulfate in women with mild preeclampsia

A randomized controlled trial

Jeffrey C. Livingston, Lisa W. Livingston, Risa Ramsey, Bill C. Mabie, Baha M. Sibai

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

OBJECTIVE: To determine whether magnesium sulfate prevents disease progression in women with mild preeclampsia. METHODS: A total of 222 women with mild preeclampsia were randomized to receive intravenous magnesium sulfate (n = 109) or matched placebo (n = 113). Mild preeclampsia was defined as blood pressure of at least 140/90 mm Hg taken on two occasions in the presence of new-onset proteinuria. Patients with chronic hypertension or severe preeclampsia were excluded. Patients were considered to have disease progression if they developed signs or symptoms of severe preeclampsia, eclampsia, or laboratory abnormalities of full or partial HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. RESULTS: The groups were similar with respect to maternal age, ethnicity, gestational age, parity, and maternal weight at enrollment. Fourteen women (12.8%) in the magnesium group and 19 (16.8%) in the placebo group developed severe preeclampsia after randomization (relative risk = 0.8, 95% confidence interval 0.4, 1.5, P = .41). None in either group developed eclampsia or thrombocytopenia. Women assigned magnesium had similar rates of cesarean delivery (30% versus 25%), chorioamnionitis (3% versus 2.7%), endometritis (5.3% versus 4.3%), and postpartum hemorrhage (1% versus 0.9%), compared to those assigned placebo. Neonates born to women assigned magnesium had similar mean Apgar scores at 1 and 5 minutes as those born to women assigned placebo (7.7 ± 1.5 versus 7.8 ± 1.6 and 8.7 ± 0.7 versus 8.8 ± 0.6, respectively). CONCLUSION: Magnesium sulfate does not have a major impact on disease progression in women with mild preeclampsia. Magnesium use does not seem to increase rates of cesarean delivery, infectious morbidity, obstetric hemorrhage, or neonatal depression.

Original languageEnglish (US)
Pages (from-to)217-220
Number of pages4
JournalObstetrics and Gynecology
Volume101
Issue number2
DOIs
StatePublished - Feb 1 2003

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Magnesium Sulfate
Pre-Eclampsia
Randomized Controlled Trials
Magnesium
Placebos
Disease Progression
Eclampsia
Surrogate Mothers
Chorioamnionitis
Endometritis
Postpartum Hemorrhage
Apgar Score
Maternal Age
Random Allocation
Hemolysis
Parity
Proteinuria
Thrombocytopenia
Gestational Age
Obstetrics

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Magnesium sulfate in women with mild preeclampsia : A randomized controlled trial. / Livingston, Jeffrey C.; Livingston, Lisa W.; Ramsey, Risa; Mabie, Bill C.; Sibai, Baha M.

In: Obstetrics and Gynecology, Vol. 101, No. 2, 01.02.2003, p. 217-220.

Research output: Contribution to journalArticle

Livingston, Jeffrey C. ; Livingston, Lisa W. ; Ramsey, Risa ; Mabie, Bill C. ; Sibai, Baha M. / Magnesium sulfate in women with mild preeclampsia : A randomized controlled trial. In: Obstetrics and Gynecology. 2003 ; Vol. 101, No. 2. pp. 217-220.
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AB - OBJECTIVE: To determine whether magnesium sulfate prevents disease progression in women with mild preeclampsia. METHODS: A total of 222 women with mild preeclampsia were randomized to receive intravenous magnesium sulfate (n = 109) or matched placebo (n = 113). Mild preeclampsia was defined as blood pressure of at least 140/90 mm Hg taken on two occasions in the presence of new-onset proteinuria. Patients with chronic hypertension or severe preeclampsia were excluded. Patients were considered to have disease progression if they developed signs or symptoms of severe preeclampsia, eclampsia, or laboratory abnormalities of full or partial HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. RESULTS: The groups were similar with respect to maternal age, ethnicity, gestational age, parity, and maternal weight at enrollment. Fourteen women (12.8%) in the magnesium group and 19 (16.8%) in the placebo group developed severe preeclampsia after randomization (relative risk = 0.8, 95% confidence interval 0.4, 1.5, P = .41). None in either group developed eclampsia or thrombocytopenia. Women assigned magnesium had similar rates of cesarean delivery (30% versus 25%), chorioamnionitis (3% versus 2.7%), endometritis (5.3% versus 4.3%), and postpartum hemorrhage (1% versus 0.9%), compared to those assigned placebo. Neonates born to women assigned magnesium had similar mean Apgar scores at 1 and 5 minutes as those born to women assigned placebo (7.7 ± 1.5 versus 7.8 ± 1.6 and 8.7 ± 0.7 versus 8.8 ± 0.6, respectively). CONCLUSION: Magnesium sulfate does not have a major impact on disease progression in women with mild preeclampsia. Magnesium use does not seem to increase rates of cesarean delivery, infectious morbidity, obstetric hemorrhage, or neonatal depression.

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