Epsom salt
In order to bring attention to the life-threatening pregnancy condition Pre-eclampsia, many health organizations observed World Pre-eclampsia Day on May 22, which allowed PATH the perfect opportunity to share its progress with an innovation that uses Epsom salt to save lives.

The nonprofit global health organization’s new innovation aims to make preventive solutions for pre-eclampsia and eclampsia more accessible in lower-income countries.

Every day about 800 women dies from preventable pregnancy-related causes, like pre-eclampsia and eclampsia, according to the World Health Organization (WHO). The WHO also reported that 99 percent of these maternal deaths take place in low-income countries.

How Is Epsom Salt Used to Save Lives?

Beginning in the 20th century, doctors discovered that Epsom salt worked as a method of treating pre-eclampsia, a condition that results in high-blood pressure and damage to the liver and kidneys, among other symptoms.

Despite its name, Epsom salt is not a salt at all, but rather it is magnesium sulfate and is known to prevent and deter convulsions that are common with pre-eclampsia and eclampsia, according to a historical report published by the National Center for Biotechnology Information (NCBI).

For women in countries with more resources, magnesium sulfate is administered to them through an intravenous (IV) infusion before, during and after childbirth. Women in countries without access to reliable electricity cannot use IVs and must obtain the magnesium sulfate treatment via intramuscular injections which can be more painful, according to PATH.

While nearly 90 percent of the world’s population has access to electricity, stated by the World Bank data, 59 percent of healthcare facilities in low and middle-income countries lack access to reliable electricity, according to a report published on Science Direct. 

What Is PATH Doing About It?

Besides access to electricity, IV infusions can be difficult for low-income countries to access, taking into account the cost of purchasing, training and replacing parts. Knowing this, PATH began to develop a technology that would allow for a more reliable method of injecting medicine without the need for extensive training or electricity.

It took PATH innovators a few years to find the perfect technology that was simultaneously affordable, easy to use and did not need batteries or electricity. Ultimately, the group decided on using a bicycle pump, according to an article written by one of the developers, resulting in RELI Delivery System, or reusable, electricity-free, low-cost infusion delivery system.

The bicycle pump was able to have consistent delivery rates into the patient with just a few manual hand pumps. In 2016, PATH was able to produce a prototype and received two awards: the Saving Lives at Birth seed award and an honorary Peer Choice award.

The next step for the RELI Delivery System is to use the money from the awards and donations to PATH and follow the system in Rwanda and Uganda to see it work in action and gain feedback.

How Effective Is This Treatment?

A 2002 study conducted by The Magpie Trial Collaboration Group found that the use of magnesium sulfate halves the risk of eclampsia in pregnant women with pre-eclampsia. The same results were supported by a 2010 study conducted by several groups including the Centre for Epidemiology and Biostatistics, University of Leeds and Bradford Institute for Health Research.

In 2011, WHO recognized magnesium sulfate as a priority medicine for mothers for major causes of reproductive and sexual health mortality and morbidity.

Although the use of magnesium sulfate can ultimately save women’s lives, there are some side effects that come along with the treatment, including skin flushing (more common with intramuscular injections), nausea and vomiting, drowsiness, confusion, muscle weakness and abscesses.

While something as simple as Epsom salt being used to save lives is innovative in itself, developers, like those at PATH, are continuously working to ensure that everyone has equal access to these health benefits.

Makenna Hall
Photo: Pixabay

Although rare in most western countries, pre-eclampsia or eclampsia is the second leading cause of maternal deaths, and is a preventable and treatable condition. There are several risk factors that contribute to the onset of pre-eclampsia and its frequency as a cause of maternal and child deaths.

The most common and obvious risk factor is poverty and substandard medical care. With the impact of the condition and its prevalence in the developing world, magnesium sulfate stands out as a successful and low-cost drug that works as both treatment and a preventive measure against unnecessary suffering and loss of life.

Pre-eclampsia is a dangerous form of high blood pressure during pregnancy that causes blood vessels to constrict, limiting the amount of oxygen and nutrients delivered to mother and child. Eclampsia develops as a more severe form of pre-eclampsia in pregnant women who have seizures or convulsions. Left untreated it can cause damage to kidneys, liver, and lungs. It can eventually lead to unconsciousness or coma and also maternal death. It can cause low birth weight and even the death of the baby.

The treatment of and preventing pre-eclampsia with magnesium sulfate, or MgS04 has proven to be an effective anticonvulsant. Eclampsia is a leading cause of maternal death, and an estimated 76,000 die each year because of the condition. Not only is it preventable, but for many who die from eclampsia it is an issue of having access to basic medical care and a functioning health care system.

MgS04 is recognized by the World Health Organization as the safest and most effective treatment for eclampsia. It is also the cheapest treatment available and is included by many countries on their Essential Medicine List. This makes its application in maternal health not only a successful medical treatment but an effective tool in combating maternal and child deaths and helps in meeting the Millennium Development Goal of reducing global maternal deaths by 75 percent by 2015.

Pre-eclampsia rarely occurs in the West and has a much greater toll on the global poor. With little profit to be made and those most needing it the world’s poor there is little incentive for manufacturers to produce MgS04, and effective dosages and administration of the drug still remain undeveloped and unenforced.

There are poorly developed national standards and guidelines and there aren’t many well developed programs available to offer a safe and consistent supply chain, and only 48 percent of countries have consistent access to the drug for their citizens.

Nearly 10 million women develop pre-eclampsia each year; however most will have access to treatment and successfully recover. Those who don’t survive most likely come from remote and impoverished regions and have poor or little access to health providers. The inconsistent and under-funded supply of MgS04 and other measures used to treat and prevent maternal health complications mean an estimated 500,000 children die unnecessarily each year due to pre-eclampsia and eclampsia.

Effectively researching, funding, and administering maternal health has effects on both women and their children and has the potential to save lives and prevent suffering.

– Nina Verfaillie
Feature Writer

Sources: University of Maryland Medical Center, Every Woman Every Child, Preclampsia
Photo: CNN