Magnesium sulfate is usually the first-line prevention and treatment option for eclampsia. It may help to reduce the risk of serious outcomes, including the death of the pregnant person.

Eclampsia is the term for seizures that occur in pregnancy or the postpartum period. It is a rare but serious potential complication of preeclampsia.

Preeclampsia is a condition that can occur during pregnancy or the postpartum period. It causes high blood pressure and can negatively affect how organs work.

This article looks at magnesium as a treatment for eclampsia, including its effectiveness, possible side effects, and other treatment options.

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According to a 2021 review, magnesium sulfate is the first-line treatment for helping to prevent and treat eclampsia.

Research in the review suggests magnesium sulfate may reduce the risk of eclampsia compared with antiseizure medications.

Overall, the authors conclude that magnesium sulfate is an effective preventive and treatment for eclampsia and for decreasing the risk of death of the pregnant person.

People may receive magnesium in a delivery ward or intensive care unit. A doctor may administer magnesium sulfate through an intravenous (IV) injection (into a vein) or an intramuscular (IM) injection (into a muscle).

According to a 2021 article, doctors may administer an initial IV dose, followed by an IV maintenance dose. They may refer to this as the Zuspan regimen.

An older regimen, known as the Pritchard regimen, involved two doses of magnesium, including one IV dose over 5–10 minutes, followed by an IM dose into each buttock.

A doctor would also administer maintenance doses every 4 hours into alternate buttocks. However, this regimen is no longer common in the United States.

People cannot treat eclampsia by themselves or with other sources of magnesium, such as Epsom salts or oral supplements. There is no evidence to show that these sources of magnesium can treat preeclampsia or eclampsia or help prevent fatal outcomes.

Taking magnesium orally will not provide a high enough level to treat eclampsia. The condition requires IV or IM treatment with magnesium sulfate.

It is possible for magnesium sulfate to cause an overdose, so doctors will closely monitor magnesium sulfate administration.

If kidney damage occurs due to preeclampsia, a person’s urine output may decrease. Since the kidneys will no longer remove magnesium from the blood, a person may experience an excessive blood magnesium level.

A doctor may place a catheter in the bladder to monitor levels of urine output.

People will require an initial loading IV dose of magnesium sulfate over the course of 15–20 minutes with subsequent maintenance dosing. The treatment should continue for at least 24 hours following the last seizure.

The kidneys excrete almost 90% of the magnesium in urine within 24 hours following an IV infusion.

To treat eclampsia, people require a plasma concentration of 1.8–3.0 millimoles per liter of magnesium. “Plasma concentration” refers to the levels of a drug or substance in the plasma of the blood.

Doctors will closely monitor a person’s magnesium level to ensure it does not exceed this concentration and become toxic.

Magnesium sulfate may cause the following side effects:

However, symptoms typically resolve once treatment ends.

Magnesium sulfate treatment does have risks, and an overdose is possible. Complications may arise if the magnesium concentration in the blood becomes too high, causing toxicity. This may lead to:

Doctors will closely monitor people while they administer magnesium sulfate to check for any signs of toxicity to help prevent complications.

Magnesium sulfate is the first-line treatment option for eclampsia. Other treatment options may include antiepileptic drugs such as diazepam (Valium) or phenytoin (Dilantin).

However, these alternative treatments are not necessarily superior to magnesium, and doctors may only resort to them in certain circumstances.

Doctors may prescribe sedative medications, such as benzodiazepines or barbiturates, to treat eclampsia that does not respond to magnesium treatment.

If people have myasthenia gravis, a chronic autoimmune disease, then magnesium or phenytoin is not suitable as it can cause an increase in muscle weakness. This may lead to myasthenia crisis, which is a medical emergency.

Instead, doctors may prescribe levetiracetam (Keppra) or valproic acid for people with myasthenia gravis and eclampsia.

Eclampsia is a severe condition that causes seizures during pregnancy or the postpartum period. This condition can be life threatening without prompt treatment.

Magnesium sulfate is the first-line treatment for eclampsia. Doctors will administer the substance via IV or IM injection.

People will receive an initial dose and maintenance doses over the course of several hours. During this time, doctors will monitor people closely for signs of complications or overdose.