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Shortened postpartum magnesium sulfate treatment vs traditional 24h for severe preeclampsia: a systematic review and meta-analysis of randomized trials

Journal

HYPERTENSION IN PREGNANCY
Volume 39, Issue 2, Pages 186-195

Publisher

TAYLOR & FRANCIS INC
DOI: 10.1080/10641955.2020.1753067

Keywords

Preeclampsia; eclampsia; meta-analysis; postpartum; magnesium sulfate

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Objectives: This meta-analysis aimed to compare the benefits and risks of shortened magnesium sulfate with traditional 24 h for severe postpartum preeclampsia. Methods: We systematically searched the Cochrane, Embase, Web of science and Pubmed database from inception till May 15 2019. Studies included type is limited to randomized controlled trial (RCT). Pooled risks difference (RDs), odds risks (ORs), mean difference (MD), standard mean difference (SMD) and 95% confifidence intervals (CIs) were used to summarize the effect sizes. Results: Totally studies included are 7 randomized controlled trials (RCTs). Shortened magnesium sulfate treatment has the same risk as eclampsia (RD 0.00, 95%CI-0.01-0.01) and total complications (OR 0.78, 95% CI 0.53-1.15), however, significant difference was observed in both groups pertaining to flushing (OR 0.40, 95% CI 0.20-0.82), and the need for prolonged treatment (RD 0.05, 95% CI 0.01 - 0.1), Others factors,namely the benefits of shortened magnesium sulfate treatment,showed differences in both groups. Conclusions: Shortened postpartum magnesium sulfate treatment was as effective as traditional 24 h magnesium sulfate in seizure prevention and total complications. But flushing and needed for prolonged treatment in the shortened groups warrants further research.

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