Prevention of preeclampsia and eclampsia

There have been many randomized trials to determine whether preeclampsia/eclampsia, a major cause of maternal and perinatal mortality and morbidity, can be prevented. Most were designed to evaluate whether low-dose aspirin regimens prevent preeclampsia. The results subjected to meta-analysis revealed a 10% reduction in the incidence of preeclampsia in women assigned low-dose aspirin, but very little improvement in morbid outcomes. There were least 10 randomized trials in which prevention by calcium supplementation (1.5 to 2 g/d) was evaluated, their results subjected to two systematic reviews whose conclusions conflict. Other trials evaluated use of fish oil or vitamins C and E supplementation for the prevention of preeclampsia in low- and high-risk pregnant women. Through 2013 these latter studies have all been negative. There have also been randomized trials evaluating use of magnesium sulfate to prevent eclampsia, demonstrating a reduction in the rate of seizures by one half.