Eclampsia and Pre-Eclampsia

Giving birth should be a time for celebration, but for more than half a million women each year—one every minute—pregnancy and childbirth end in death and mourning. Ninety-nine percent of these deaths occur in developing countries, and nearly all are preventable.

One of the leading causes of maternal death is pre-eclampsia—the rapid elevation of blood pressure during pregnancy—which, if untreated, can lead to seizures (eclampsia), kidney and liver damage, and ultimately, death. Eclampsia and severe pre-eclampsia claim the lives of an estimated 63,000 women each year, as well as the lives of many of their babies.  

A Ready Solution
The World Health Organization recognizes and recommends injectable magnesium sulfate—also known as Epsom salts—as the safest, most effective, and lowest-cost medication for treating pre-eclampsia and eclampsia. Magnesium sulfate is the standard treatment for these conditions in the developed world and has been for 20 years. Less-effective and riskier medications (such as diazepam and phenytoin), however, are still widely used in developing countries—if any treatment is available at all.

Clinton Global Initiative Commitment
This disparity must end. EngenderHealth, the University of Oxford, and the John D. & Catherine T. MacArthur Foundation are making a joint commitment as part of the Clinton Global Initiative to expand access to magnesium sulfate by:

• Training health professionals through web-based interactive teaching to know when and how to administer magnesium sulfate
• Advocating for magnesium sulfate to be part of every developing country’s list of essential drugs
• Helping develop and/or reinforce national protocols mandating magnesium sulfate as the preferred treatment for pre-eclampsia and eclampsia
• Ensuring the availability of magnesium sulfate in hospitals

Call to Action
In 2007, EngenderHealth and the University of Oxford brought together leading scientists, advocates, researchers, and representatives of the WHO, UNICEF, United Nations agencies, and national ministries of health from around the world to identify barriers to the availability and use of magnesium sulfate to treat pre-eclampsia and eclampsia. This historic gathering of global public health experts identified the primary barriers to the use of magnesium sulfate: lack of national guidelines, a shortage of educated and trained health care professionals, and scarce supplies of magnesium sulfate.

Based on these conclusions, EngenderHealth and the University of Oxford developed a “Call to Action” and report that called on policy makers and ministers of health to make pre-eclampsia and eclampsia a higher priority and to set national guidelines for treatment and care based on WHO guidelines.  Decision makers and international and national health organizations and agencies were also urged to help make magnesium sulfate more available and affordable.

The full report, Balancing the Scales: Expanding Treatment for Pregnant Women with Life-Threatening Hypertensive Conditions in Developing Countries, is available for download (PDF, 316KB), as is the International Call to Action (PDF, 27KB).