1 g/h magnesium sulfate maintenance for eclampsia prevention is enough.

Publication/Presentation Date

5-1-2026

Abstract

We conducted two systematic reviews including only randomized controlled trials (RCTs) comparing magnesium sulfate vs placebo/no treatment, as well as 2 g/h vs 1 g/h magnesium sulfate maintenance regimens for prevention of eclampsia. Medline, Cochrane Library, EMBASE, PubMed Central, Scopus, ClinicalTrial.gov were electronically searched from their inception to February 2025. In the five RCTs comparing magnesium sulfate vs placebo/no treatment, a 2-g maintenance dose was used in two RCTs including 176 pregnancies, while a 1 g maintenance dose was used in three RCTs including 5447 pregnancies. Eclampsia incidence was 0.57% with the 2 g/h regimen and 0.76% with the 1 g/h regimen (OR 1.33, 95% CI: 0.18-9.60), while maternal side effects were significantly higher in the 2 g/h regimen (67% vs 22%, OR 7.05, 95% CI: 4.22-11.78). In the five RCTs (n = 283) comparing 2 g/h vs 1 g/h maintenance regimens, no case of eclampsia was reported with either regimen, and maternal side effects were significantly higher in the 2 g/h group (71% vs 42%, OR 1.69, 95% CI: 1.06-2.71). In conclusion, magnesium sulfate maintenance regimen of 1 g/h seems as effective as the 2 g/h regimen for the prevention of eclampsia, with decreased incidence of maternal side effects.

Volume

105

Issue

5

First Page

771

Last Page

777

ISSN

1600-0412

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

41949178

Department(s)

Administration and Leadership

Document Type

Article

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