A Comparison of Magnesium Sulfate and Nimodipine for the Prevention of Eclampsia

In this randomized, unblinded, multicenter study, magnesium sulfate proved more effective than nimodipine, a cerebral vasodilator, in preventing seizures in women with severe preeclampsia. The risk of seizure was three times as high in the group given nimodipine as in the group given magnesium sulfate. The risk of seizure was higher in the nimodipine group. Cerebral infarction and hemorrhage still account for the majority of deaths from eclampsia and preeclampsia. 1 , 2 Preeclampsia causes regional vasoconstriction, and many believe that eclampsia results from cerebral vasospasm and resultant ischemia. 3 – 6 Magnesium sulfate is generally accepted as the treatment of choice for eclampsia. 7 – 9 The use of magnesium sulfate to prevent eclampsia has been common in the United States for decades 10 , 11 but has not been internationally adopted. The placebo-controlled Magnesium Sulphate for Prevention of Eclampsia (MAGPIE) trial 12 recently confirmed the prophylactic action of magnesium sulfate and is likely to increase the use of this agent in women . . .