Successful magnesium sulfate tocolysis: is “weaning” the drug necessary

Lewis, David F.; Bergstedt, S.; Adair, Charles; Edwards, MJ; Burlison, Scott; Gallaspy, J. W.; Brooks, G. G.

doi:10.1016/s0002-9378(97)80085-3

Cited by 7 publications

(4 citation statements)

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“…GA was established based on an ultrasonographic examination before 20 wk in all instances. PTL was defined as the presence of regular uterine contractions and documented cervical effacement and/or dilatation in patients Ͻ37 wk GA (16). The diagnosis of PPROM was confirmed by visualization of AF pooling through the cervical os, nitrazine, ferning, or amniocentesis-dye positive tests.…”

Section: Methodsmentioning

confidence: 99%

Proteomic Biomarkers of Intra-amniotic Inflammation: Relationship with Funisitis and Early-onset Sepsis in the Premature Neonate

Buhimschi

Abdel-Razeq

et al. 2007

Pediatr Res

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ABSTRACT:Our goal was to determine the relationship between 4 amniotic fluid (AF) proteomic biomarkers (human neutrophil defensins 2 and 1, calgranulins C and A) characteristic of intra-amniotic inflammation, and funisitis and early-onset sepsis in premature neonates. The mass restricted (MR) score was generated from AF obtained from women in preterm labor (n ϭ 123). The MR score ranged from 0 -4 (none to all biomarkers present). Funisitis was graded histologically and interpreted in relation to the MR scores. Neonates (n ϭ 97) were evaluated for early-onset sepsis. There was significant correlation between the severity of AF inflammation and the presence (53/123) and grades of funisitis (p Ͻ 0.001). Funisitis occurred independently of the amniocentesis-to-delivery interval or status of the membranes and was best predicted by an MR score 3-4 and an earlier gestational age (GA) at delivery. Neonates born to women with an MR score 3-4 had an increased incidence of suspected/confirmed sepsis, even after adjusting for GA at birth. Calgranulin C had the highest association with clinically significant funisitis, while calgranulin A had the strongest association with early-onset sepsis. To conclude, AF proteomic analysis shows that women with MR scores 3-4 are more likely to have histologic funisitis, and deliver neonates with early-onset sepsis. the rate of preterm birth (PTB) has actually increased over the past 20 y (1). More than 500,000 preterm infants were born in the United States in 2004 (1). Interventions to prevent PTB and its consequences for the fetus should predominantly be targeted at the prevention, early recognition and treatment of several risk factors including intra-amniotic inflammation/ infection (2).Robust scientific evidence has confirmed that when intraamniotic inflammation secondary to, or independent of infection is superimposed upon prematurity, the consequences for the neonate can prove devastating (3,4). This association can be explained by an inflammatory cytokine cascade that seems to be, at least partially, of fetal origin (5,6). Indeed, fetal umbilical vein inflammatory cytokine levels, but not maternal serum values, correlate with the presence and severity of the placental histologic inflammation and umbilical cord vasculitis (7).Funisitis is characterized by perivascular infiltrates of inflammatory cells and is considered one of the strongest hallmarks of microbial invasion of the amniotic cavity and fetal inflammatory syndrome (8,9). While there is some debate with regard to the origin of the amniotic fluid (AF) neutrophilic response to infection (10), there is consensus that the fetal inflammatory neutrophilic response originates initially from the umbilical vein and later from the arteries leading to umbilical cord vasculitis and funisitis (11). Funisitis is a well-recognized risk factor for early-onset sepsis in the premature neonate (12,13).We have previously shown that proteomic mapping of the AF reveals a profile, designated as the Mass Restricted (MR) score, that is highly cha...

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Section: Methodsmentioning

confidence: 99%

Proteomic Biomarkers of Intra-amniotic Inflammation: Relationship with Funisitis and Early-onset Sepsis in the Premature Neonate

Buhimschi

Abdel-Razeq

et al. 2007

Pediatr Res

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“…Magnesium ions are involved as a cofactor in about 300 known enzymatic reactions in the body and in several important processes such as hormone receptor binding, gating of calcium channels, transmembrane ion¯ux, regulation of the adenylcyclase system, muscle contraction, neuronal activity, vaso-motor tone, cardiac excitability and neurotransmitter release [1]. As a pharmacological agent the use of magnesium sulphate is established for the treatment of supraventricular [2] and ventricular dysrhythmias [3], especially torsades de pointes [4], asthma [5], for tocolysis [6] and eclampsia [7,8]. The role of magnesium in the treatment of acute myocardial infarction remains unclear [1,9].…”

Section: Introductionmentioning

confidence: 99%

Magnesium as part of balanced general anaesthesia with propofol, remifentanil and mivacurium: a double-blind, randomized prospective study in 50 patients

Schulz-Stübner

Wettmann

Reyle-Hahn

et al. 2001

European Journal of Anaesthesiology

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Background and objective To test the hypothesis that magnesium sulphate reduces the amount of remifentanil needed for general anaesthesia in combination with propofol and mivacurium, we studied 50 patients undergoing elective pars plana vitrectomy in a double-blind, randomized prospective fashion. Methods Magnesium sulphate (50 mg kg ±1 body weight) or placebo (equal volume of NaCl) was given slowly intravenously after induction of anaesthesia with propofol 1±2 mg kg ±1 . Anaesthesia was maintained with propofol (using electroencephalographic control), mivacurium (according to train-of-four monitoring of neuromuscular blockade) and remifentanil (according to heart rate and arterial pressure). Results We observed a signi®cant reduction in remifentanil consumption from 0.14 to 0.09 lg kg ±1 min ±1 (P < 0.01). Mivacurium consumption was also markedly reduced from 0.01 to 0.008 mg kg ±1 min ±1 (P < 0.01), whereas propofol consumption remained

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“…Magnesium ions are involved as a cofactor in about 300 known enzymatic reactions in the body and in several important processes such as hormone receptor binding, gating of calcium channels, transmembrane ion flux, regulation of the adenylcyclase system, muscle contraction, neuronal activity, vasomotor tone, cardiac excitability and neurotransmitter release [1]. As a pharmacological agent the use of magnesium sulphate is established for the treatment of supraventricular [2] and ventricular dysrhythmias [3], especially torsades de pointes [4], asthma [5], for tocolysis [6] and eclampsia [7,8]. The role of magnesium in the treatment of acute myocardial infarction remains unclear [1,9].…”

Section: Introductionmentioning

confidence: 99%

Magnesium as part of balanced general anaesthesia with propofol, remifentanil and mivacurium: a double-blind, randomized prospective study in 50 patients

et al. 2001

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We can recommend the use of magnesium sulphate as a safe and cost-effective supplement to a general anaesthetic regimen with propofol, remifentanil and mivacurium, although we cannot clearly distinguish between a mechanism as a (co)analgesic agent at the NMDA-receptor site or its properties as a sympatholytic. The effect of a single bolus dose of 50 mg kg(-1) on induction lasts for about 2 h. For longer cases, either a continuous infusion or repeated bolus doses might be necessary.

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Successful magnesium sulfate tocolysis: is “weaning” the drug necessary

Cited by 7 publications

References 0 publications

Proteomic Biomarkers of Intra-amniotic Inflammation: Relationship with Funisitis and Early-onset Sepsis in the Premature Neonate

Proteomic Biomarkers of Intra-amniotic Inflammation: Relationship with Funisitis and Early-onset Sepsis in the Premature Neonate

Magnesium as part of balanced general anaesthesia with propofol, remifentanil and mivacurium: a double-blind, randomized prospective study in 50 patients

Magnesium as part of balanced general anaesthesia with propofol, remifentanil and mivacurium: a double-blind, randomized prospective study in 50 patients

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