Evolution of magnesium sulphate for eclampsia

Imaralu, John Osaigbovoh; Imaralu, JO

doi:10.15406/ogij.2018.09.00391

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…The results of this retrospective analysis of magnesium levels in a population of patients with SAH carries several implications regarding the monitoring and the prospect of identifying vasospasm. Although prior studies have mixed results in the effectiveness of magnesium as a treatment for vasospasm [5][6][7], a temporal association used to predict vasospasm is revealed by our results. While patients who did not experience clinical vasospasm showed no relationship when magnesium levels trended downwards, these results demonstrate that patients who do experience vasospasm had a significant moderate relationship in decreasing magnesium levels compared with periods of active vasospasm.…”

Section: Discussionmentioning

confidence: 55%

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Magnesium Levels and Diastolic Blood Pressure (DBP) as a Vasospasm Prediction Metric in Patients With Aneurysmal Subarachnoid Hemorrhage (SAH)

Savla¹,

Marino²,

Marotta³

et al. 2022

Cureus

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IntroductionVasospasm is a significant cause of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study is to evaluate a possible link between vasospasm in patients with aneurysmal SAH and magnesium and blood pressure levels. MethodsSubjects were selected based on chart review of patients presenting to a comprehensive stroke center in Southern California with aneurysmal SAH. 27 were included based on the following criteria: patients greater than 18 years of age, aneurysmal SAH, clinically symptomatic vasospasms and at least one diagnostic confirmation -either from a transcranial doppler (TCD) or digital subtraction angiogram (DSA). The following exclusion criteria also applied: 1) incomplete documentation in the medical record; 2) patients <18 years of age; and 3) patients without TCD measurements. ResultsIn an overall analysis of all patients with or without vasospasm, it was found that the presence of vasospasm was significantly correlated with diastolic blood pressures (DBPs) on day of vasospasm with an r value of 0.418 and p<0.001. Average daily DBPs throughout hospital stay were also correlated with vasospasm with an r-value of 0.455 and p<0.001. Changes in magnesium overall were also significantly related to left Lindegaard ratios with an r value of -0.201 and p value of 0.032. Lindegaard ratios were significantly correlated with age with r values of 0.510, p<0.001, and r=-0.482, p<0.001 for left and right, respectively. A change in magnesium was inversely correlated to the left Lindegaard ratio with an n of 31 and p value of 0.014 (r= -0.439) in patients with vasospasm. We also found a lower incidence of vasospasm in patients older than 65. ConclusionMonitoring magnesium and increases in DBP might be effective as a prophylactic adjunct method in patients with SAH in an effort to predict clinical vasospasm.

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Section: Discussionmentioning

confidence: 55%

“…The timing of which phenomenon occurs first has not been established. The body, in response to vasospasm, may be consuming high levels of magnesium for its vasodilatory effect, which could lead to low serum levels of magnesium [ 7 ]. However, it is possible that magnesium levels are low due to a different cause in SAH patients.…”

Section: Introductionmentioning

confidence: 99%

Magnesium Levels and Diastolic Blood Pressure (DBP) as a Vasospasm Prediction Metric in Patients With Aneurysmal Subarachnoid Hemorrhage (SAH)

Savla¹,

Marino²,

Marotta³

et al. 2022

Cureus

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Factors associated with pharmacologic serum concentration of Magnesium and corresponding obstetric outcomes among women with severe pre-eclampsia at Iringa Regional Referral Hospital

Kileo,

matovelo,

Kitinusa

2024

Preprint

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Severe pre-eclampsia is managed by using Magnesium sulphate to prevent its progress into eclampsia with a success rate of more than 50%. This study aimed at establishing reliable data pertaining factors influencing pharmacologic serum concentration of Magnesium and their correlation to obstetric outcomes. This study was carried out at Iringa regional referral hospital, spanning six months from November 2023 to April 2024. A convenient sampling technique was used to recruit 121 pre-eclamptic patients. Recruited women were tested serum Magnesium at admission, 4 and 12 hours post initial administration of MgSO4. IBM SPSS version 29 was used for analysis where, Continuous variables were analyzed by using median and interquartile range while categorical variables were analyzed using frequency and percentages. The associations between variables were determined using chi-square tests, univariate, and multivariate binary regression models. A p value<0.05 was considered statistically significant. Results: The median age of participants were (29±10 IQR), the median serum Mg at admission was (0.8±0.29 IQR) Mmol/L majority with low 53(43.8%) levels. Proportion of subtherapeutic serum Mg was 38.8% with median of (1.9±1.02 IQR) Mmol/L. Multivariate regression showed that; low serum Mg at admission [p<0.001, OR= 9.17, 95% CI (3.07- 27.37)], Creatinine level [p = 0.012, OR= 4.49, 95% CI (1.38- 14.6)], Overweight [p= 0.002, OR= 5.52, 95% CI (1.83- 16.68)] and proteinuria +++[p-value = 0.004, OR= 7.13, 95% CI (1.84- 26.86)] were significantly associated with subtherapeutic level. After adjusting with other factors, it was found that subtherapeutic level [p<0.001, OR=25.44(5.73-112.90)], elevated creatinine [p=0.040, OR=3.59(1.66-12.15)], Reduced urine output [p=0.001, OR=6.69(2.15-20.90)] were significant predictors of adverse maternal outcomes. Conclusion: Subtherapeutic serum Magnesium which significantly predict adverse obstetric outcomes, is influenced by factors which can be monitored and be useful in effective management of severe pre-eclampsia. This can help in administering tailored dose of MgSO4 for better outcomes.

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Evolution of magnesium sulphate for eclampsia

Cited by 2 publications

References 20 publications

Magnesium Levels and Diastolic Blood Pressure (DBP) as a Vasospasm Prediction Metric in Patients With Aneurysmal Subarachnoid Hemorrhage (SAH)

Magnesium Levels and Diastolic Blood Pressure (DBP) as a Vasospasm Prediction Metric in Patients With Aneurysmal Subarachnoid Hemorrhage (SAH)

Factors associated with pharmacologic serum concentration of Magnesium and corresponding obstetric outcomes among women with severe pre-eclampsia at Iringa Regional Referral Hospital

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