According to the Magpie Trial, magnesium sulfate compared to phenytoin for seizure prophylaxis in women with severe pre-eclampsia showed which of the following outcomes?
- A 50% reduction in risk of eclampsia with no difference in maternal mortality ✓
- B Similar seizure reduction but significantly less maternal death
- C Magnesium sulfate inferior for seizure prevention but superior for neonatal outcomes
- D No difference in seizure rate but significant reduction in stroke risk
Correct answer: A. 50% reduction in risk of eclampsia with no difference in maternal mortality
Explanation
The Magpie Trial (2002) — a landmark RCT of over 10,000 women — demonstrated that magnesium sulfate reduced the risk of eclampsia by approximately 58% compared to placebo, and by about 52% compared to phenytoin, establishing it as the anticonvulsant of choice. Maternal mortality was reduced in the magnesium arm though this did not reach statistical significance in all subgroups. Option B incorrectly states outcomes without the seizure-reduction benefit being recognized.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.