The use of magnesium sulfate as the primary tocolytic agent to prevent premature delivery

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

doi:10.1016/s0002-9378(16)32529-7

Cited by 63 publications

(6 citation statements)

References 7 publications

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“…In this regard, magnesium, one of the trace elements, has become the subject of interest [ 15 ]. Hypomagnesaemia during pregnancy decreases the magnesium level in myometrium and a low magnesium concentration in pregnant human myometrium could be a cause of preterm labour [ 16 – 18 ]. Rising serum magnesium level serves to relax the uterine smooth muscle, thereby providing the basis for the previous use of magnesium sulphate as a tocolytic agent in pregnancy in North America [ 14 , 19 ], although a Cochrane systematic review has now concluded that it is ineffective as a tocolytic agent and may even be harmful to the unborn baby [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour

Okunade

Oluwole

Adegbesan-Omilabu

2014

Advances in Medicine

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Objectives. The study was aimed to assess the association between low maternal serum magnesium levels and preterm labour. Methods. It is a cross-sectional case-control study in which eligible participants were pregnant women admitted in labour within the labour ward complex of a Lagos tertiary hospital. Relevant data were extracted from the case records of these women and blood samples were obtained from all participants and serum magnesium levels measured. Results. The study showed that 36% of the study patients had varying degrees of hypomagnesaemia. The relative risk indicates that preterm labour is 1.83 times higher among the patients with low serum magnesium (less than 1.6 mg/dL). The mean difference in serum magnesium levels in both groups was statistically significant (P<0.05). Conclusion. We can infer that low serum magnesium (hypomagnesaemia) is associated with preterm onset of labour. We can, also from this finding, formulate a proposition that would help in preventing preterm labour and birth with the use of prophylactic oral magnesium supplementation among patients with higher risk for development of preterm labour.

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Section: Introductionmentioning

confidence: 99%

A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour

Okunade

Oluwole

Adegbesan-Omilabu

2014

Advances in Medicine

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“…Our success rates are comparable to those reported in the literature. [10][11][12][15][16][17][18] Our second question addressed the more important issue of the impact on neonatal outcome and maternal morbidity. We hypothesized that aggressive management to delay delivery would be justified if we were able to demonstrate improved neonatal outcome with minimal maternal morbidity.…”

Section: Discussionmentioning

confidence: 99%

Tocolysis in Advanced Preterm Labor: Impact on Neonatal Outcome

Veciana¹,

Porto²,

Major³

et al. 1995

Amer J Perinatol

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Chart review of 73 patients with 3.5 cm or more dilation, intact membranes, and regular contractions at less than 36 weeks. Forty-four (group A) received tocolysis with magnesium sulfate, and 13 of the 44 also received indomethacin. Twenty-nine (group B) received no tocolysis. Obstetric and neonatal outcomes were compared. Demographic factors and admission gestational age, cervical dilation, effacement, and uterine activity were similar. Twenty-one of the 44 in group A versus 3 of 29 in group B had delivery delayed by more than 48 hours (p = 0.002). Group A had a lower incidence of severe respiratory distress syndrome; 4 of 48 babies in group A versus 9 of 32 in group B (p = 0.04; RR = 0.47; confidence interval [CI], 0.2, 1.0). Tocolysis in advanced preterm labor delays delivery by more than 48 hours in 50% of patients. The neonatal benefits of aggressive tocolysis in cases with advanced cervical dilation may outweigh the potential maternal risks of tocolysis, particularly in the setting of extreme prematurity. Delay in delivery enabling steroid enhancement of pulmonary maturity reduces the severity of respiratory distress syndrome.

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“…The results of the present investigation demonstrate for the first time that Mg does pass the BBB in developing swine within the first postnatal month, and to a greater extent in the younger than in the older animals. This is clinically relevant because neonatal hypermagnesia can occur as a consequence of treatment of the mother with Mg; for example, as a tocolytic agent to prevent premature delivery (9,10). Excess Mg produces a wide variety of effects including skeletal muscle paralysis, respiratory depression, and changes in cardiovascular function.…”

Section: Discussionmentioning

confidence: 99%

Effects of Elevated Plasma Magnesium Concentration on Cerebrospinal Fluid Levels of Magnesium in Neonatal Swine

Rivera

Gootman

Lin

et al. 1991

Experimental Biology and Medicine

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To determine whether magnesium (Mg) can cross the blood brain barrier in developing swine, simultaneous measurements of [Mg] in plasma and cerebrospinal fluid (CSF) were made during experimental elevation of plasma [Mg] in 12 swine of differing postnatal age. All were anesthetized with Saffan and maintained at normal arterial blood gas composition. Aortic pressure and heart rate were monitored. Plasma and CSF samples, drawn at the beginning and end of a 60-min intravenous infusion of MgCl2 in all animals and every 10 min during the infusion in three, were analyzed for [Mg] and osmolality. CSF [Mg] increased in all animals as plasma [Mg] increased. There were no changes in CSF osmolality. The differences between plasma and CSF [Mg] was smallest in the youngest animals. These results indicate that Mg crosses the blood brain barrier in neonatal swine and suggest that the blood brain barrier is still maturing within the first postnatal month.

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The use of magnesium sulfate as the primary tocolytic agent to prevent premature delivery

Cited by 63 publications

References 7 publications

A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour

A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour

Tocolysis in Advanced Preterm Labor: Impact on Neonatal Outcome

Effects of Elevated Plasma Magnesium Concentration on Cerebrospinal Fluid Levels of Magnesium in Neonatal Swine

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