Combination of Magnesium Sulfate with Other Treatments in Managing Severe Preeclampsia: A Systematic Review

Abstract

Introduction: Preeclampsia is a pregnancy complication occurring after 20 weeks of gestation and characterized by blood pressure ≥140/90 mmHg. It can cause serious maternal and fetal complications and remains an important contributor to maternal and fetal mortality. Magnesium sulfate (MgSO₄) and antihypertensive agents are commonly used to prevent seizures and control blood pressure in severe preeclampsia.

Objective: This study aimed to review the effectiveness of MgSO₄ combined with antihypertensive therapies in the management of severe preeclampsia and their effects on maternal and fetal outcomes. Method: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. Literature searches were conducted in PubMed, ScienceDirect, PMC Europe, and Springer Link. From 966 identified articles, 10 studies were selected based on the established selection criteria and analyzed through qualitative synthesis.

Result: The reviewed studies showed that MgSO₄ combined with antihypertensive agents, including labetalol, hydralazine, and nifedipine, effectively managed severe preeclampsia by preventing seizures and controlling blood pressure. These therapies were associated with improved maternal and neonatal outcomes, including reduced risks of premature birth and neonatal asphyxia. Additional therapies, such as sodium enoxaparin and Compound Danshen, were reported to support placental blood flow and fetal development.

Conclusion: The combination of MgSO₄ and antihypertensive therapy is beneficial in managing severe preeclampsia and improving maternal and fetal outcomes. Further research with well-designed studies is needed to strengthen evidence regarding the effectiveness and safety of these therapeutic approaches..

Keywords: Preeclampsia, Magnesium sulfate, Maternal outcomes, Neonatal outcomes