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Objective  To characterise the current clinical practice patterns regarding the use of magnesium sulphate (Mg SO  4 ) for eclampsia prevention and treatment in a multi‐country network of health facilities and compare with international recommendations.    Design  Cross‐sectional survey.    Setting  A total of 147 health facilities in 15 countries across Africa, Latin America and Asia.    Population  Heads of obstetric departments or maternity units.    Methods  Anonymous online and paper‐based survey conducted in 2015.    Main outcome measures  Availability and use of Mg SO  4 ; availability of a formal clinical protocol for Mg SO  4  administration; and Mg SO  4  dosing regimens for eclampsia prevention and treatment.    Results  Magnesium sulphate and a formal protocol for its administration were reported to be always available in 87.4% and 86.4% of all facilities, respectively. Mg SO  4  was used for the treatment of mild pre‐eclampsia, severe pre‐eclampsia and eclampsia in 24.3%, 93.5% and 96.4% of all facilities, respectively. Regarding the treatment of severe pre‐eclampsia, 26.4% and 7.0% of all facilities reported using dosing regimens that were consistent with Zuspan and Pritchard regimens, respectively. Across regions, intramuscular maintenance regimens were more commonly used in the African region (45.7%) than in the Latin American (3.0%) and Asian (22.9%) regions, whereas intravenous maintenance regimens were more often used in the Latin American (94.0%) and Asian (60.0%) regions than in the African region (21.7%). Similar patterns were found for the treatment of eclampsia across regions.    Conclusions  The reported clinical use of Mg SO  4  for eclampsia prevention and treatment varied widely, and was largely inconsistent with current international recommendations.    Tweetable abstract  Mg SO  4  regimens for eclampsia prevention and treatment in many hospitals are inconsistent with international recommendations.

Clinical practice patterns on the use of magnesium sulphate for treatment of pre‐eclampsia and eclampsia: a multi‐country survey