MAGPIE Trial Flashcards
What year, and in what journal was the MAGPIE Trial published?
2002
The Lancet
What was the aim of the MAGPIE Trial?
To evaluate the effects of MgSO4 on women and their babies
To find out if, overall, women with PET or their children, or both, do better if they are given MgSO4 rather than placebo, regardless of whether treatment is started before or after delivery and irrespective of any previous anticonvulsant therapy
What was the setting of the MAGPIE Trial?
33 countries
1998-2001
Low, middle, high perinatal mortality countries
How many women were recruited to the MAGPIE Trial?
10 141 women
What were the inclusion criteria for the MAGPIE Trial?
Not given birth OR less than 24h postpartum
PET dx as BP > 140/90 and proteinuria
Clinical uncertainty about MgSO4
Irrespective of whether they had an anticonvulsant at a referring hospital
Singleton or multiple
What were the exclusion criteria of the MAGPIE Trial?
Hypersensitivity to magnesium
Hepatic coma with a risk of renal failure
Myasthenia Gravis
What were the two exposure groups in the MAGPIE Trial?
MgSO4
- 4g loading dose over 10-15 minutes
- 1g/h maintenance therapy for 24h
- halved if oliguric <25mL/h
Placebo
IV or IM
What were the two primary outcomes of the MAGPIE trial?
Eclampsia
Death of baby
What were the secondary outcomes of the MAGPIE Trial?
Serious maternal morbidity
Toxicity
Side effects of MgSO4
What are the side effects of MgSO4 (as per the MAGPIE trial)
Nausea, vomiting, flushing of the skin, drowsiness, confusion, muscle weakness, abscess
Also palpitations
What was the effect of Mg on eclampsia, in the MAGPIE Trial?
Was it statistically significant?
Decreased risk
0.8% in Mg group and 1.9% in placebo
RR 0.42
Statistically significant
What was the effect of Mg on death of baby, in the MAGPIE Trial?
Was it statistically significant?
No clear difference
What was the effect of Mg on maternal mortality, in the MAGPIE Trial?
Was it statistically significant?
Non-significant reduction in Mg group
Not powered for this
Which route of Mg administration was more effect of reducing eclampsia and death of baby?
IV > IM
What was the conclusion of the MAGPIE Trial?
MgSO4 halves the risk of eclampsia and probably reduces the risk of maternal death
There do not appear to be substantive harmful effects to the mother or baby in the short term
