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Participants were adult pregnant women admitted to the Korle Bu Teaching Hospital (KBTH) with a diagnosis of antepartum, intrapartum, or postpartum eclampsia or preeclampsia with severe features, having received no more than a loading dose of magnesium sulfate prior to admission at KBTH. Participants in the standard 24\u2010h group received a loading dose of magnesium sulfate 4\u00a0g intravenous and 10\u00a0g intramuscular (5\u00a0g in each buttock) followed by six, 5\u00a0g intramuscular maintenance doses over 24\u00a0h. Participants in the 12\u2010h intervention group received the same loading dose followed by three, 5\u00a0g intramuscular maintenance doses over 12\u00a0h. The primary outcome was occurrence of seizure after completion of the assigned magnesium sulfate regimen. Secondary outcomes were magnesium sulfate toxicity, magnesium sulfate side effects, maternal outcomes (mode of delivery, duration of inpatient admission, duration of urethral catheterization), maternal complications (pulmonary edema, acute kidney injury, intensive care unit admission, death), and neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1176 total participants, we found no difference in occurrence of seizure after completion of the assigned regimen in the 24\u2010h group (<jats:italic>n\u2009=<\/jats:italic>\u00a05, 0.9%) versus the 12\u2010h group (<jats:italic>n\u2009=<\/jats:italic>\u00a02, 0.3%), <jats:italic>P\u2009=<\/jats:italic>\u00a00.29; RR 0.40, 95% CI 0.08, 2.04), or in occurrence of seizure any time after enrollment (<jats:italic>n\u2009=<\/jats:italic>\u00a09, 1.5% vs. <jats:italic>n\u2009=<\/jats:italic>\u00a05, 0.9%, <jats:italic>P\u2009=<\/jats:italic>\u00a00.28, RR 0.55, 95% CI 0.19\u20131.64). Participants in the 12\u2010h group had a shorter duration of inpatient admission (9.4\u00a0\u00b1\u20098.8 vs. 7.7\u00a0\u00b1\u20096.5\u2009days, <jats:italic>P\u2009=<\/jats:italic>\u00a00.0009) and urethral catheterization (2.1\u00a0\u00b1\u20091.0 vs. 1.9\u00a0\u00b1\u20091.3\u2009days, <jats:italic>P\u2009&lt;<\/jats:italic>\u00a00.0001). Rates of side effects from magnesium sulfate were lower in the 12\u2010h group: pain at the injection site (94.8% (<jats:italic>n\u2009=<\/jats:italic>\u00a0548) vs. 91.5% (<jats:italic>n\u2009=<\/jats:italic>\u00a0540), <jats:italic>P\u2009=<\/jats:italic>\u00a00.03), inflammation (62.2% (<jats:italic>n\u2009=<\/jats:italic>\u00a0358) vs. 40.0% (<jats:italic>n\u2009=<\/jats:italic>\u00a0237), <jats:italic>P\u2009&lt;<\/jats:italic>\u00a00.0001), and bleeding or bruising at the injection site (25.1% (<jats:italic>n\u2009=<\/jats:italic>\u00a0144) vs. 14.4% (<jats:italic>n\u2009=<\/jats:italic>\u00a085), <jats:italic>P\u2009&lt;<\/jats:italic>\u00a00.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with 24\u00a0h, 12\u2009h of intramuscular magnesium sulfate showed similar rates of seizures, with fewer side effects and shorter inpatient admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Prospective registration was with Pan African Clinical Trial Registry (PACTR201811515303983): <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/pactr.samrc.ac.za\/TrialDisplay.aspx?TrialID=4690\">https:\/\/pactr.samrc.ac.za\/TrialDisplay.aspx?TrialID=4690<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14181","type":"journal-article","created":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T07:19:26Z","timestamp":1647674366000},"page":"495-504","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["A novel 12\u2010hour versus 24\u2010hour magnesium sulfate regimen in the management of eclampsia and preeclampsia in Ghana (<scp>MOPEP<\/scp> Study): A randomized controlled trial"],"prefix":"10.1002","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3706-4695","authenticated-orcid":false,"given":"Titus K.","family":"Beyuo","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Ghana Medical School  Accra Ghana"},{"name":"Department of Obstetrics and Gynaecology Korle\u2010Bu Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9606-7071","authenticated-orcid":false,"given":"Emma R.","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3121-2079","authenticated-orcid":false,"given":"Emily K.","family":"Kobernik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3836-1376","authenticated-orcid":false,"given":"Samuel A.","family":"Oppong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Ghana Medical School  Accra Ghana"},{"name":"Department of Obstetrics and Gynaecology Korle\u2010Bu Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2009.02.010"},{"key":"e_1_2_9_3_1","unstructured":"WHO.WHO recommendations for Prevention and treatment of pre\u2010eclampsia and eclampsia. 2011. 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