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Epsom salts can more than halve the risk of a common pregnancy said: " Virtually all UK units already use magnesium sulphate for eclamptic fits, but not all yet.
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Epsom salts injected into the bloodstream can more than halve the risk of a common pregnancy complication becoming life-threatening, doctors revealed today. Researchers said the findings from a major international trial involving more than 10,000 women were so dramatic they would were likely to have an instant impact on the treatment of pre-eclampsia. The three-year £2.5 million "Magpie" study was conducted in 33 countries, including the UK. It showed that women given magnesium sulphate - commonly used as Epsom salts to soak away aches and pains - had a 58% reduced risk of pre-eclampsia progressing to eclampsia. Pre-eclampsia, a condition that affects up to 10% of pregnancies, causes a surge of blood pressure, accumulation of fluid in tissues, and protein in the urine. If untreated it can lead to eclampsia, a highly dangerous condition which produces seizures due to a lack of blood to the brain. Magnesium sulphate treatment is widely used in the US for eclamptic conditions but much less commonly in the UK and not employed at all in many other countries. Doctors involved in the Magpie trial believe it will swiftly lead to the treatment becoming a universal standard. Its impact in the UK may be limited since in Britain it is rare for a woman to develop eclampsia. About 700 women a year are affected by pre-eclampsia in the UK but only 1% to 2% go on to develop eclampsia. The conditions kill about three or four women but up to 1,000 babies in the UK each year. However, in developing countries eclampsia is a major killer and it is here that treatment with magnesium sulphate is likely to reap the most rewards. Magnesium sulphate is very cheap - an entire treatment costing only about £3 or £4. Yet many underdeveloped countries have no access to the drug. Dr Lelia Duley, a Medical Research Council Senior Clinical Fellow at Oxford University, who led the trial, said: "Eclampsia is a devastating condition that can kill both mother and child. "Our trial has shown that giving magnesium sulphate injections halves the risk of developing eclampsia in women who already have pre-eclampsia, and it seems likely it also reduces the risk of maternal death. "The treatment could save countless lives across the world if it was introduced routinely for pregnant women with pre-eclampsia. And, importantly, it is a very inexpensive treatment, making it especially suitable for use in low income countries." She suspected the lack of availability of magnesium sulphate in many parts of the world was down to the fact that it was not a money spinner. "I think one factor is that it's too cheap for drug companies to be interested in," she said. The trial results were published today in the Lancet medical journal. They showed that the treatment had the bonus benefit of cutting by a third the risk of placental eruption, another serious complication which can kill a baby. Jim Neilson, Professor of Obstetrics and Gynaecology at the University of Liverpool, who worked on the trial, said he was convinced clinical practice would change as a result of the findings. He said: "Often after trials there may be some uncertainty about whether a treatment should be implemented on a widespread basis. "In this case the findings were very clear-cut and clearly indicate that women with moderate or severe pre-eclampsia should have access to magnesium sulphate. "I'm sure we will see a very rapid change of practice in the UK and other countries as a result of this trial." Claire Giles, 32, from Heston, west London, who took part in the trial, recalled the horrific experience of her first pregnancy when she developed pre-eclampsia. She was 32-weeks pregnant when she began to develop swelling, but at first did not realise anything was seriously wrong. "By 38 weeks I was so swollen my back was like a water bed," she told a news conference at the Medical Research Council in London. "My legs measured three foot round each. My feet were so swollen my toes were an inch off the ground." After she was admitted to hospital doctors asked if she would be willing to join the trial. "I felt so ill and was in so much pain from all the swelling I think I would have agreed to anything," she said. Her baby Matthew was delivered by Caesarean section on October 13 1999 and has grown into a healthy child. Mrs Giles had her second son, Thomas, in August last year. Mike Rich, chief executive of the patient support group Action on Pre-eclampsia (Apec) said: "The good thing about this trial and the changes it will probably have on treatment is that women who have severe pre-eclampsia and are taken to hospital can be given a relatively simple treatment that will more than halve their likelihood of developing eclampsia, which is a major factor in pregnancy death. "However, while it is fantastic news we also have to bear in mind that for women in the UK suffering from eclampsia is an exceptionally rare experience." Magnesium sulphate bath crystals have been used as far back as Shakespeare's time as a remedy for aches and pains. "Epsom salts" originated from the mineral-rich waters of Epsom, Surrey, 17th Century England's first spa town. But Dr Duley stressed that on no account should women attempt to treat themselves for pre-eclampsia with magnesium sulphate. Women taking part in the trial were either given with the drug via an intravenous drip or offered a course of injections. "This is a hospital-based treatment and something women should not even contemplate doing themselves," Dr Duley said. A Department of Health spokeswoman said: "Virtually all UK units already use magnesium sulphate for eclamptic fits, but not all yet use it routinely for women with less severe disease. "We would expect those units not already using it to change practice as soon as possible - where appropriate."
Epsom salts could cut pregnancy risks