New Drug Therapies for Women with Eclampsia – Impact on Prognosis as Compared to Standard Treatment: A Systematic Review of Randomized Controlled Trials

Abstract

Hypertensive disorders continue to be a major global health concern, impacting millions of pregnant women annually, and have a significant impact on both the mortality and morbidity rates of mothers and neonates. The two major spectrums of disease are pre-eclampsia (PE) and eclampsia. While pre-eclampsia (PE) is characterized by milder symptoms, eclampsia includes hypertensive symptoms plus impaired brain function and seizures or coma. This systematic review aims to explore safer and novel drugs/drug combinations with minimal adverse effects to the mother and fetus, which will cause a rapid decrease in blood pressure, better bioavailability, and prevent life-threatening complications. The PubMed and PubMed Central databases were used to perform a comprehensive literature review from January 2019 to December 2023. The Mesh terms and Boolean operators used were “Pre-eclampsia” OR “Eclampsia” AND “Drug therapy.” There are novel and promising alternatives to mono-therapeutic magnesium sulfate in the treatment of severe PE and eclampsia. These drugs are namely dexmedetomidine, nifedipine in combination with phytosterol, magnesium sulfate, and compound Danshen combinations. The use of these drugs is, however off-label in nature and should be instituted solely on a case-by-case basis at the discretion of the physician. The prospect of a combination therapy being developed from the above drug groups is promising, and these findings should instigate further research to provide the next generation of pharmacotherapeutic treatment protocols to combat severe PE and eclampsia.