( 8 June )
mit Magnesium- Sulfat können während der Schwangerschaft
das Risiko lebensbedrohlicher Eklampsieanfälle um 50% senken.
Die Therapie ist billig - daher ist sie auch geeignet, die Müttersterblichkeit
in Entwicklungsländern drastisch abzusenken.
Quelle: BMJ 2002;324:1351 ( 8 June )
Magnesium could save hundreds of women's lives worldwide
Lynn Eaton, London
Magnesium sulphate injections have been shown to halve the risk
of eclampsia in pregnant women and can save their lives, concludes
a major clinical trial published in this week's Lancet (2002;359:1877-90).
Over 10000 women from 33 countries, many of them in the developing
world, took part in the three year, £2.5m ($3.7m; 3.9m) research
study, funded by the UK Medical Research Council. All the women
had pre-eclampsia. Half were randomly assigned to be given magnesium
sulphate, an anticonvulsant, and the other half were given a placebo.
The women given magnesium sulphate had a 58% lower risk of developing
eclampsia than women given a placebo. Although a quarter of the
women given magnesium sulphate reported minor side effects, such
as flushing and prickly skin, there was no evidence of harmful
effects to the mother or baby, say the researchers. Moreover,
although the treatment did not affect whether or not the baby
died, it did reduce the risk of the mother dying.
The study, known as the Magpie (Magnesium sulphate for prevention
of eclampsia) trial, is the first major controlled trial to
come up with reliable empirical evidence supporting the benefits
of magnesium sulphate. The drug has been used in the United States
for over a century. A systematic review published in 1998 (Lancet
1998:325;1861), the collaborative eclampsia trial, involving 1687
women in nine developing countries, concluded that magnesium sulphate
was the most promising choice for pre-eclampsia. It had a dramatic
effect on practice in the United Kingdom.
Previously, doctors worldwide had relied on diazepam, phenytoin,
lytic cocktail, and a number of other anticonvulsant treatments
to reduce the risk of seizure in women who already had pre-eclampsia.
A quarter of UK obstetricians never use prophylactic anticonvulsants,
and those who do restrict them to women with the most severe pre-eclampsia.
Dr Lelia Duley, senior clinical fellow with the Medical Research
Council and an obstetric epidemiologist in the Institute of Health
Sciences, Oxford University, said the treatment
could save countless lives if it were introduced routinely for
pregnant women with pre-eclampsia. "Importantly," she
said, "it is a very inexpensive treatment, making it especially
suitable for use in low income countries."