Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial.
Background: Anticonvulsants are used for pre-eclampsia in the belief they prevent eclamptic convulsions, and so improve outcome. Evidence supported magnesium sulphate as the drug to evaluate.Methods: Eligible women (n=10141) had not given birth or were 24 h or less postpartum; blood pressure of 140/...
| Publicado en: | Lancet Vol. 359; no. 9321; pp. 1877 - 1891 |
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| Autores principales: | , , , , , , |
| Formato: | clinical trial research randomized controlled trial Journal Article |
| Publicado: |
Lancet
6/1/2002
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=119541193&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 119541193 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 6/1/2002 vid: 359 iid: 9321 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 119541193 NLM12057549 119541193 10.1016/S0140-6736(02)08778-0 NLM12057549 119541193 ppf: 1877 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. aug: au: Altman, Douglas Carroli, Guillermo Duley, Lelia Farrell, Barbara Moodley, Jack Neilson, James Smith, David sug: subj: Magnesium Sulfate Therapeutic Use Perinatal Death Pre-Eclampsia Prevention and Control Anticonvulsants Therapeutic Use Pregnancy Treatment Outcomes Anticonvulsants Adverse Effects Gestational Age Blood Pressure Maternal Mortality Human Cause of Death Pre-Eclampsia Diagnosis Magnesium Sulfate Adverse Effects Pre-Eclampsia Drug Therapy Infant, Newborn Female Clinical Trials Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Questionnaires Scales Short Portable Mental Status Questionnaire Infant, Newborn: birth-1 month Female ab: Background: Anticonvulsants are used for pre-eclampsia in the belief they prevent eclamptic convulsions, and so improve outcome. Evidence supported magnesium sulphate as the drug to evaluate.Methods: Eligible women (n=10141) had not given birth or were 24 h or less postpartum; blood pressure of 140/90 mm Hg or more, and proteinuria of 1+ (30 mg/dL) or more; and there was clinical uncertainty about magnesium sulphate. Women were randomised in 33 countries to either magnesium sulphate (n=5071) or placebo (n=5070). Primary outcomes were eclampsia and, for women randomised before delivery, death of the baby. Follow up was until discharge from hospital after delivery. Analyses were by intention to treat.Findings: Follow-up data were available for 10,110 (99.7%) women, 9992 (99%) of whom received the allocated treatment. 1201 of 4999 (24%) women given magnesium sulphate reported side-effects versus 228 of 4993 (5%) given placebo. Women allocated magnesium sulphate had a 58% lower risk of eclampsia (95% CI 40-71) than those allocated placebo (40, 0.8%, vs 96, 1.9%; 11 fewer women with eclampsia per 1000 women). Maternal mortality was also lower among women allocated magnesium sulphate (relative risk 0.55, 0.26-1.14). For women randomised before delivery, there was no clear difference in the risk of the baby dying (576, 12.7%, vs 558, 12.4%; relative risk 1.02, 99% CI 0.92-1.14). The only notable difference in maternal or neonatal morbidity was for placental abruption (relative risk 0.67, 99% CI 0.45-0.89).Interpretation: Magnesium sulphate halves the risk of eclampsia, and probably reduces the risk of maternal death. There do not appear to be substantive harmful effects to mother or baby in the short term. pubtype: Academic Journal doctype: clinical trial research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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