Cochrane · systematic review · CD007388
Alternative magnesium sulphate regimens for women with pre‐eclampsia and eclampsia
Diaz, V, Long, Q, Oladapo, OT · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
61
current version
GRADE rated
34
No studies
27
Included studies
NR
No studies 27 · 44.3%Ungraded 0 · 0%Very low 26 · 42.6%Low 8 · 13.1%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Treatment of eclampsia: loading dose alone compared to loading dose plus maintenance dose regimen for women with eclampsia
Population: women with eclampsia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrence of convulsion Treatment of eclampsia: loading dose alone vs loading dose plus maintenance dose regimen | RR 4.32 [0.21, 87.18] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Severe morbidity Treatment of eclampsia: loading dose alone vs loading dose plus maintenance dose regimen | no estimate extracted | NR | No studies |
Side effects Treatment of eclampsia: loading dose alone vs loading dose plus maintenance dose regimen | no estimate extracted | NR | No studies |
Death of the baby before discharge from hospital Treatment of eclampsia: loading dose alone vs loading dose plus maintenance dose regimen | no estimate extracted | NR | No studies |
Maternal death Treatment of eclampsia: loading dose alone vs loading dose plus maintenance dose regimen | RR 2.59 [0.11, 61.75] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Other neonatal morbidity Treatment of eclampsia: loading dose alone vs loading dose plus maintenance dose regimen | no estimate extracted | NR | No studies |
Treatment of eclampsia: lower‐dose regimens compared to standard‐dose regimens for women with eclampsia
Population: women with eclampsia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrence of convulsions: lower dose versus Pritchard regimen Treatment of eclampsia: lower‐dose regimens vs standard‐dose regimens | RR 1.69 [0.16, 17.84] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Severe morbidity (renal failure): lower dose versus Pritchard regimen Treatment of eclampsia: lower‐dose regimens vs standard‐dose regimens | RR 0.85 [0.06, 13.01] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Side effects Treatment of eclampsia: lower‐dose regimens vs standard‐dose regimens | no estimate extracted | NR | No studies |
Death of the baby before discharge: perinatal death: lower dose versus Pritchard regimen Treatment of eclampsia: lower‐dose regimens vs standard‐dose regimens | RR 1.52 [0.57, 4.1] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Maternal death Treatment of eclampsia: lower‐dose regimens vs standard‐dose regimens | RR 0.28 [0.03, 2.58] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Other neonatal morbidity Treatment of eclampsia: lower‐dose regimens vs standard‐dose regimens | no estimate extracted | NR | No studies |
Treatment of eclampsia: IV maintenance compared to standard IM maintenance regimen for women with eclampsia
Population: women with eclampsia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrence of convulsions Treatment of eclampsia: IV maintenance vs standard IM maintenance regimen | RR 0.87 [0.28, 2.72] | 1 study · 137 participants | Very low Downgraded: risk of bias, imprecision |
Severe morbidity Treatment of eclampsia: IV maintenance vs standard IM maintenance regimen | no estimate extracted | NR | No studies |
Side effects Treatment of eclampsia: IV maintenance vs standard IM maintenance regimen | no estimate extracted | NR | No studies |
Death of the baby before discharge: stillbirth Treatment of eclampsia: IV maintenance vs standard IM maintenance regimen | RR 0.87 [0.28, 2.72] | 1 study · 137 participants | Very low Downgraded: risk of bias, imprecision |
Death of the baby before discharge: neonatal death Treatment of eclampsia: IV maintenance vs standard IM maintenance regimen | RR 0.75 [0.25, 2.24] | 1 study · 137 participants | Very low Downgraded: risk of bias, imprecision |
Maternal death Treatment of eclampsia: IV maintenance vs standard IM maintenance regimen | RR 0.35 [0.04, 3.27] | 1 study · 137 participants | Very low Downgraded: risk of bias, imprecision |
Other neonatal morbidity Treatment of eclampsia: IV maintenance vs standard IM maintenance regimen | no estimate extracted | NR | No studies |
Treatment of eclampsia: duration of postpartum maintenance regimen: short compared to 24 hours after delivery for women with eclampsia
Population: women with eclampsia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrence of convulsions Treatment of eclampsia: duration of postpartum maintenance regimen: short vs 24 hours after delivery | no estimate extracted | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Severe morbidity: renal failure Treatment of eclampsia: duration of postpartum maintenance regimen: short vs 24 hours after delivery | no estimate extracted | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Side effect: respiratory failure Treatment of eclampsia: duration of postpartum maintenance regimen: short vs 24 hours after delivery | no estimate extracted | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Side effect: nausea Treatment of eclampsia: duration of postpartum maintenance regimen: short vs 24 hours after delivery | RR 0.14 [0.02, 1.13] | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Side effect: flushing Treatment of eclampsia: duration of postpartum maintenance regimen: short vs 24 hours after delivery | RR 0.27 [0.08, 0.93] | 1 study · 120 participants | Low Downgraded: risk of bias, imprecision |
Death of the baby before discharge from hospital Treatment of eclampsia: duration of postpartum maintenance regimen: short vs 24 hours after delivery | no estimate extracted | NR | No studies |
Maternal death Treatment of eclampsia: duration of postpartum maintenance regimen: short vs 24 hours after delivery | no estimate extracted | NR | No studies |
Other neonatal morbidity Treatment of eclampsia: duration of postpartum maintenance regimen: short vs 24 hours after delivery | no estimate extracted | NR | No studies |
Prevention of eclampsia: loading dose alone compared to loading dose + maintenance regimen for women with pre‐eclampsia
Population: women with pre‐eclampsia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Eclampsia Prevention of eclampsia: loading dose alone vs loading dose + maintenance regimen | RR 2 [0.61, 6.54] | 2 studies · 462 participants | Low Downgraded: risk of bias, imprecision |
Severe morbidity Prevention of eclampsia: loading dose alone vs loading dose + maintenance regimen | no estimate extracted | NR | No studies |
Side effects Prevention of eclampsia: loading dose alone vs loading dose + maintenance regimen | no estimate extracted | NR | No studies |
Death of the baby before discharge: perinatal death Prevention of eclampsia: loading dose alone vs loading dose + maintenance regimen | RR 0.5 [0.19, 1.36] | 2 studies · 462 participants | Low Downgraded: risk of bias, imprecision |
Death of the baby before discharge: stillbirth Prevention of eclampsia: loading dose alone vs loading dose + maintenance regimen | RR 0.17 [0.02, 1.3] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal death Prevention of eclampsia: loading dose alone vs loading dose + maintenance regimen | RR 0.63 [0.27, 1.46] | 2 studies · 462 participants | Low Downgraded: risk of bias, imprecision |
Maternal death Prevention of eclampsia: loading dose alone vs loading dose + maintenance regimen | no estimate extracted | 2 studies · 462 participants | Very low Downgraded: risk of bias, imprecision |
Other neonatal morbidity Prevention of eclampsia: loading dose alone vs loading dose + maintenance regimen | no estimate extracted | NR | No studies |
Prevention of eclampsia: IV maintenance compared to standard IM maintenance regimen for women with pre‐eclampsia
Population: women with pre‐eclampsia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Eclampsia Prevention of eclampsia: IV maintenance vs standard IM maintenance regimen | no estimate extracted | 1 study · 17 participants | Very low Downgraded: risk of bias, imprecision |
Severe morbidity Prevention of eclampsia: IV maintenance vs standard IM maintenance regimen | no estimate extracted | NR | No studies |
Side effects Prevention of eclampsia: IV maintenance vs standard IM maintenance regimen | no estimate extracted | NR | No studies |
Death of the baby before discharge: stillbirth Prevention of eclampsia: IV maintenance vs standard IM maintenance regimen | RR 0.37 [0.02, 7.99] | 1 study · 17 participants | Very low Downgraded: risk of bias, imprecision |
Maternal death Prevention of eclampsia: IV maintenance vs standard IM maintenance regimen | no estimate extracted | NR | No studies |
Other neonatal morbidity Prevention of eclampsia: IV maintenance vs standard IM maintenance regimen | no estimate extracted | NR | No studies |
Prevention of eclampsia: short compared to standard maintenance regimen (subgroups by type of short regimen) for women with pre‐eclampsia
Population: women with pre‐eclampsia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Eclampsia Prevention of eclampsia: short vs standard maintenance regimen (subgroups by type of short regimen) | RR 1.99 [0.18, 21.87] | 4 studies · 1713 participants | Low Downgraded: risk of bias |
Severe morbidity Prevention of eclampsia: short vs standard maintenance regimen (subgroups by type of short regimen) | RR 0.96 [0.71, 1.29] | 2 studies · 1233 participants | Low Downgraded: risk of bias |
Side effect: respiratory depression Prevention of eclampsia: short vs standard maintenance regimen (subgroups by type of short regimen) | RR 0.8 [0.25, 2.61] | 2 studies · 1424 participants | Low Downgraded: risk of bias |
Death of the baby before discharge from hospital Prevention of eclampsia: short vs standard maintenance regimen (subgroups by type of short regimen) | no estimate extracted | NR | No studies |
Maternal death Prevention of eclampsia: short vs standard maintenance regimen (subgroups by type of short regimen) | no estimate extracted | NR | No studies |
Other neonatal morbidity Prevention of eclampsia: short vs standard maintenance regimen (subgroups by type of short regimen) | no estimate extracted | NR | No studies |
Prevention of eclampsia: higher compared to lower IV maintenance regimen for women with pre‐eclampsia
Population: women with pre‐eclampsia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Eclampsia Prevention of eclampsia: higher vs lower IV maintenance regimen | no estimate extracted | 2 studies · 148 participants | Very low Downgraded: imprecision |
Eclampsia: 2 g per hour IV maintenance versus 1 g per hour IV maintenance Prevention of eclampsia: higher vs lower IV maintenance regimen | no estimate extracted | 1 study · 62 participants | Very low Downgraded: imprecision |
Eclampsia: 2 g per hour IV versus weight‐adjusted maintenance dose Prevention of eclampsia: higher vs lower IV maintenance regimen | no estimate extracted | 1 study · 86 participants | Very low Downgraded: imprecision |
Severe morbidity Prevention of eclampsia: higher vs lower IV maintenance regimen | no estimate extracted | NR | No studies |
Side effects Prevention of eclampsia: higher vs lower IV maintenance regimen | RR 0.79 [0.61, 1.01] | 1 study · 62 participants | Low Downgraded: imprecision |
Death of the baby before discharge from hospital Prevention of eclampsia: higher vs lower IV maintenance regimen | no estimate extracted | NR | No studies |
Maternal death Prevention of eclampsia: higher vs lower IV maintenance regimen | no estimate extracted | NR | No studies |
Other neonatal morbidity Prevention of eclampsia: higher vs lower IV maintenance regimen | no estimate extracted | NR | No studies |
Prevention of eclampsia: maintenance regimen by continuous infusion compared to a serial IV bolus regimen for women with pre‐eclampsia
Population: women with pre‐eclampsia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Eclampsia Prevention of eclampsia: maintenance regimen by continuous infusion vs a serial IV bolus regimen | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision |
Severe morbidity Prevention of eclampsia: maintenance regimen by continuous infusion vs a serial IV bolus regimen | no estimate extracted | NR | No studies |
Side effects Prevention of eclampsia: maintenance regimen by continuous infusion vs a serial IV bolus regimen | RR 9 [0.49, 165] | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision |
Death of the baby before discharge: perinatal death Prevention of eclampsia: maintenance regimen by continuous infusion vs a serial IV bolus regimen | RR 0.44 [0.08, 2.34] | 1 study · 197 participants | Very low Downgraded: risk of bias, imprecision |
Maternal death Prevention of eclampsia: maintenance regimen by continuous infusion vs a serial IV bolus regimen | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision |
Other neonatal morbidity: neonatal respiratory morbidity Prevention of eclampsia: maintenance regimen by continuous infusion vs a serial IV bolus regimen | RR 0.66 [0.29, 1.49] | 1 study · 197 participants | Very low Downgraded: risk of bias, imprecision |