The Use of Magnesium Sulfate as the Primary Tocolytic Agent to Prevent Premature Delivery

Spisso, Kenneth R.; Harbert, Guy M.; Thiagarajah, Siva; Bassell, Gerard M.

doi:10.1097/00132582-198303000-00011

Cited by 8 publications

(8 citation statements)

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“…The present data on the in vitro contractile activity in human myométrial strips clearly showed a marked inhibitory effect of magnesium on both spontaneous activity and K+-induced contracture. The concentrations of magnesium used in our experi ments were calculated so that they would be compatible with those used in patients receiving intravenous admin istration of magnesium sulfate for the inhibition of pre term labor [10].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Magnesium on Calcium Uptake and Contractility in the Human Myometrium

Popper

Batra

Åkerlund

1989

Gynecol Obstet Invest

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High concentrations of magnesium (12 and 24 mM) in the extracellular medium markedly inhibited both spontaneous activity and K⁺-induced contracture in strips of nonpregnant human myometrium. Net calcium influx measured by the uptake of ⁴⁵Ca²⁺ in the myometrium was considerably decreased by high concentrations of magnesium. This was true for both resting (unstimulated) and K⁺-stimulated uptake of ⁴⁵Ca². While calcium uptake in K⁺-stimulated tissues exposed to 24 mM magnesium was significantly lower than in those exposed to 12 mM, no difference was found in the unstimulated tissues. These data indicate that the tocolytic action of magnesium most probably results from the inhibition of calcium entry into myometrial cells.

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Section: Discussionmentioning

confidence: 99%

The Effect of Magnesium on Calcium Uptake and Contractility in the Human Myometrium

Popper

Batra

Åkerlund

1989

Gynecol Obstet Invest

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“…Various effects of MgSO 4 on the fetus and neonate have been described including hypotonia [13] , hypercalciuria and parathyroid hormone suppression [14] , abnormal bone mineralization [15] , attenuated neutrophil function [16] , an increased risk of neonatal intraventricular hemorrhage [17] , patent ductus arteriosus [18] and chorioamnionitis [19] . Concerns regarding antenatal MgSO 4 effects on the fetus and the neonate relate, in part, to its vasoactive properties. MgSO 4 acts as a competitive antagonist with calcium, decreasing the intracellular free calcium that is necessary for the actin-myosin interaction of smooth muscle contractility [12] .…”

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confidence: 99%

Effects of Maternal Magnesium Sulfate Administration on Intestinal Blood Flow Velocity in Preterm Neonates

et al. 2011

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Background: Antenatal MgSO₄ administration is used extensively as a tocolytic agent and to treat preeclampsia. Various effects on the fetus and newborn have been reported, and MgSO₄ has well-documented vasoactive effects. Objective: To determine if antenatal MgSO₄ administration affects intestinal blood flow velocity in newborn preterm infants. Methods: Peak, mean and end-diastolic velocities in the superior mesenteric artery were measured on day 1 of life. Maternal medical records were reviewed to identify infants whose mothers had been administered MgSO₄ for preterm labor or preeclampsia within 24 h of delivery. Result: Fifty-six infants were studied: 27 were exposed and 29 were not exposed to antenatal MgSO₄. Mean birth weight (1,371 ± 349 and 1,401 ± 469 g, respectively), gestational age (29.7 ± 2.0 and 30.0 ± 2.9 weeks, respectively) and infant hemodynamic and clinical variables (other than clinical indication for antenatal MgSO₄ administration) were similar between groups. There were no significant differences between the exposed and unexposed groups in intestinal blood flow velocities. For the exposed group, however, there was a significant negative correlation between mean velocity and the number of hours from birth to the time superior mesenteric artery blood flow velocity measurements were made (p = 0.002); there was no correlation for the unexposed group (p = 0.852). Conclusion: Group mean values indicate that antenatal exposure to MgSO₄ does not significantly affect intestinal blood flow velocity in newborn preterm infants. However, the significant negative relationship between mean blood flow velocity and time from birth to blood flow velocity measurement in exposed infants suggests that there may be measurable effects of MgSO₄ exposure within the hours immediately after birth. Trials that prospectively evaluate the development of intestinal blood flow velocities are needed to further clarify potential effects of antenatal MgSO₄ on the gastrointestinal tract of preterm infants.

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“…When terbutaline was compared to maternal manipulations such as position change, discontinuation of oxytocin, oxygen administration, and hydration in women with acute fetal distress who required emergent caesarean delivery it was found to improve infant outcome without adverse maternal sequelae (7). Magnesium sulphate, another useful tocolytic agent (3,4) has been evaluated only in isolated case reports (8) as an agent for emergency in utero fetal resuscitation during acute fetal distress.…”

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confidence: 99%

Acute Tocolysis for Fetal Distress: Terbutaline Versus Magnesium Sulphate

Magann

Cleveland

Dockery

et al. 1993

Aust NZ J Obst Gynaeco

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Forty-six women in active labour who developed fetal distress requiring abdominal delivery were randomized to receive 0.25 mg of terbutaline (subcutaneously) or magnesium sulphate as a 4-g bolus (intravenously) to decrease uterine activity. The terbutaline-treated group in contrast to the magnesium sulphate-treated group had reduced uterine activity as measured by Montevideo units (p < 0.002). This decrease in uterine activity was noted more rapidly in all 23 patients who received terbutaline, 1.8 +/- 0.74 minutes compared to 7.5 +/- 2.1 minutes in the 16 of 23 patients (magnesium sulphate-treated women) in whom a decrease in uterine activity occurred (p < 0.001). Umbilical cord arterial blood pH at delivery was less than 7.20 in only 2 of the 23 patients treated with terbutaline versus 7 of the 23 in the magnesium sulphate-treated group. We conclude that terbutaline is an effective and more rapid-acting tocolytic agent to arrest uterine activity prior to delivery for fetal distress.

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The Use of Magnesium Sulfate as the Primary Tocolytic Agent to Prevent Premature Delivery

Cited by 8 publications

References 0 publications

The Effect of Magnesium on Calcium Uptake and Contractility in the Human Myometrium

The Effect of Magnesium on Calcium Uptake and Contractility in the Human Myometrium

Effects of Maternal Magnesium Sulfate Administration on Intestinal Blood Flow Velocity in Preterm Neonates

Acute Tocolysis for Fetal Distress: Terbutaline Versus Magnesium Sulphate

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