• E J Coetzee, J Dommisse, and J Anthony.
• Department of Obstetrics and Gynaecology, University of Cape Town, Groote Schuur Hospital, South Africa.
• Br J Obstet Gynaecol. 1998 Mar 1;105(3):300-3.

ObjectiveTo determine whether the administration of prophylactic intravenous magnesium sulphate reduces the occurrence of eclampsia in women with severe pre-eclampsia.DesignRandomised controlled trial.SettingA tertiary referral obstetric unit.PopulationEight hundred and twenty-two women with severe pre-eclampsia requiring termination of pregnancy by induction of labour or caesarean section.MethodsThe women were randomised to receive either placebo (saline) or magnesium sulphate intravenously. The investigators were blinded to the contents of the pre-mixed solutions.Main Outcome MeasureThe occurrence of eclampsia in the two groups.ResultsThe data of 699 women were evaluated. Fourteen were withdrawn after randomisation. The overall incidence of eclampsia was 1.8%. Of 345 women who received magnesium sulphate, one developed eclampsia (0.3%); in the placebo group, 11/340 women (3.2%) developed eclampsia (relative risk 0.09; 95% confidence interval 0.01-0.69; P = 0.003).ConclusionThe use of intravenous magnesium sulphate in the management of women with severe pre-eclampsia significantly reduced the development of eclampsia.

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