Duration of postpartum magnesium sulfate for seizure prophylaxis in women with preeclampsia: a systematic review and meta-analysis

Duration of Postpartum Magnesium Sulphate for the Prevention of Eclampsia

“…Shorter duration of postpartum magnesium sulphate was not associated with increased risk for eclampsia in two other recently published meta-analyses. 18,19 There were significant methodologic differences between our analysis and these published studies. Yifu et al included RCTs for women with severe preeclampsia, was not registered in PROSPERO, and did not define severe preeclampsia.…”

“…A power calculation using a 1% incidence of eclampsia estimated that more than 9,000 women would be required to demonstrate a 50% reduction in seizures with magnesium sulphate. 19 Our population included only 1,714 women; therefore, we remain underpowered to identify whether shorter-duration magnesium sulphate is associated with a reduction in seizure activity. Similarly, the heterogeneity across studies was high at 71%, limiting the generalizability of these findings.…”

“…A power calculation using a 1% incidence of eclampsia estimated that more than 9,000 women would be required to demonstrate a 50% reduction in seizures with magnesium sulphate. 19 Our population included Fig. 3.…”

“…18 The other analysis, by Sullivan et al, included RCTs with women with preeclampsia and identified nine articles; six were included in our study, and three were excluded (one for high risk of bias, one study reported the total time on magnesium sulphate that included the antepartum time and therefore lacked a group exposed to 24 hours of magnesium sulphate postpartum, and one trial included an experimental group that received different durations of postpartum magnesium sulphate). 8,[19][20][21] We therefore feel that our study is more comprehensive and clinically useful, because we included every trial including preeclampsia or eclampsia.…”

Maternal and neonatal outcomes following magnesium sulfate in the setting of chorioamnionitis: a meta-analysis

“…During pregnancy, magnesium has been administered as a treatment of several antenatal pathological entities. In the form of magnesium sulfate, it has been used to prevent eclampsia in preeclamptic patients and it has been also considered as a tocolytic agent [ 5 – 7 ]; however, given the limited amount of evidence and the lack of an evidential association between its use and actual clinical benefit for these two pathological entities, current recommendations do not include it as a treatment option. Currently, the use of magnesium sulfate is strongly recommended in cases with anticipated preterm birth as an offspring neuroprotective regimen [ 8 , 9 ].…”