Pre-eclampsia in pregnant women

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• Format Audio, Texts
• Target Audience Self-directed learning
• EBM Stage 0 - Why EBM?
• Duration <5 mins
• Difficulty Introductory

Key Concepts addressed

• 2-3d Fair comparisons with few people or outcome events can be misleading

Details

Another outstanding example of good research concerns pregnant women. Worldwide, about 600,000 women die each year of pregnancy-related complications.

Most of these deaths occur in developing countries and many are linked to pregnancy-associated convulsions (fits), a condition known as eclampsia. Eclampsia is a devastating condition that can kill both mother and baby. Women with the predisposing condition – pre-eclampsia (also known as toxaemia) – have high blood pressure and protein in their urine.

In 1995, research showed that injections of magnesium sulphate, a simple and inexpensive drug, could prevent fits recurring in women with eclampsia. The same study also showed that magnesium sulphate was better than other anticonvulsant drugs, including a much more expensive one, in stopping convulsions. So, the researchers knew it was important to find out whether magnesium sulphate could prevent convulsions occurring in women with pre-eclampsia.

[thumb]The Magpie trial, designed to answer this question, was a major achievement, involving more than 10,000 pregnant women with pre-eclampsia in 33 countries around the globe. In addition to normal medical care, half the women received an injection of magnesium sulphate and half a placebo (sham preparation).

Magpie gave clear and convincing results. It showed that magnesium sulphate more than halved the chance of convulsions occurring. In addition, although the treatment did not apparently reduce the baby’s risk of death, there was evidence that it could reduce the risk of the mother dying. And apart from minor side-effects, magnesium sulphate did not appear to harm the mother or the baby. [4, 5]

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