Document Detail


Adverse maternal and neonatal outcome of prolonged course of magnesium sulfate tocolysis.
MedLine Citation:
PMID:  16929415     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Magnesium sulfate continues to be widely used as a tocolytic agent despite a paucity of evidence supporting its use. Many practitioners use prolonged courses of magnesium sulfate, sometimes for months. This study was conducted to determine maternal and neonatal outcome of patients exposed to prolonged tocolytic magnesium sulfate. METHODS: A retrospective review of maternal and neonatal charts (1995-2003) of pregnancies that received tocolytic magnesium sulfate. Cases who received magnesium sulfate >48 h (n=78) were compared to controls who received it < or =48 h (n=77) for maternal side effects and neonatal outcome. RESULTS: Cases were more likely to be nulliparous (55.1% versus 37.7%, p=0.044), multiple gestations (33.3% versus 10.4%, p=0.001), and of lower gestational age (29.0+/-3.9 versus 30.5+/-3.8 weeks, p=0.017) compared to controls. The median magnesium sulfate infused was 154 (78-5,500) versus 54 (8-86) g (p<0.001) and the highest maternal magnesium level was 6.5+/-1.7 versus 5.6+/-1.9 mg/dl (p=0.002) in cases and controls, respectively. Cases were more likely to have > or =1 adverse side effect (30.8% versus 15.6%, p=0.045). The median neonatal magnesium level was significantly higher in cases (3.3 (1.4-7.2) versus 2.6 (1.1-5.2) mg/dl, p=0.016); however, neonatal mortality and other neonatal morbidity rates were similar in both groups. Abnormal bone mineralization was encountered in 3 neonates (cases). CONCLUSIONS: Maternal morbidity rate is higher with prolonged intake of tocolytic magnesium sulfate compared to < or =48-h regimen. Despite similar neonatal morbidity and mortality rates, bone demineralization in the neonates may be encountered.
Authors:
Anwar H Nassar; Khaled Sakhel; Hoda Maarouf; Georges R Naassan; Ihab M Usta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  85     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2006  
Date Detail:
Created Date:  2006-08-24     Completed Date:  2006-10-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1099-103     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon. an21@aub.edu.lb
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MeSH Terms
Descriptor/Qualifier:
Adult
Bone Density / drug effects*
Calcium / blood
Case-Control Studies
Female
Gestational Age
Humans
Infant Mortality
Infant, Newborn / blood*
Magnesium / blood
Magnesium Sulfate / administration & dosage,  adverse effects*
Obstetric Labor, Premature / prevention & control
Parity
Pregnancy
Pregnancy Outcome*
Retrospective Studies
Tocolysis / adverse effects*
Tocolytic Agents / administration & dosage,  adverse effects*,  blood
Chemical
Reg. No./Substance:
0/Tocolytic Agents; 7439-95-4/Magnesium; 7440-70-2/Calcium; 7487-88-9/Magnesium Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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