Magnesium Sulfate and Premature Labor

 

Topic 24: Preterm labor

Video taken from the channel: Association of Professors of Gynecology and Obstetrics (APGO)


 

Safe Use of Magnesium Sulfate in Pregnancy

Video taken from the channel: PearlCasts


 

PReCePT Using magnesium sulphate in pre-term labour

Video taken from the channel: Oxford AHSN


 

Antenatal Exposure to Magnesium Sulfate and Neuroprotection in Preterm Infants

Video taken from the channel: Learning in 10


 

Magnesium Sulphate in Obstetrics & Gynecology

Video taken from the channel: Ajit Virkud


 

Antenatal Magnesium Sulfate for the Neuroprotection of Preterm Infants

Video taken from the channel: Learning in 10


 

Preterm labor

Video taken from the channel: Ina Irabon


Magnesium Sulfate Preterm labor is defined as labor that starts before 37 weeks of pregnancy. It occurs when the uterus contracts regularly and leads to changes in the cervix. Ten percent of women. Magnesium sulfate, or mag for short, is used in pregnancy to prevent seizures due to worsening preeclampsia, to slow or stop preterm labor, and to prevent injuries to a preterm baby’s brain. Magnesium sulfate is given as an intravenous infusion or intramuscular injection in the hospital over 12 to 48 hours.

Magnesium sulfate for preterm labor and preterm birth. Approximately half of the more than 500,000 preterm births each year result from preterm labor. Tocolytic therapy continues to be the focus of treatment of these women.

Although a variety of tocolytics are used in clinical practice, magnesium sulfate remains one of the most commonly used agents. Magnesium Sulfate for Premature Labor Babies that are born prematurely are at an increased risk of experiencing health issues such as hypoxic-ischemic encephalopathy (HIE) and cerebral palsy (CP). This is because their organs are underdeveloped and more susceptible to damage from oxygen deprivation and other types of birth injury (1).

Preterm labor, or labor beginning before 37 weeks of gestation, increases the risk of birth complications and injuries as compared to babies born at term. Magnesium sulfate is a tocolytic, a medication used to suppress preterm labor, and can be used to help slow or inhibit contractions to delay the birth of a preterm baby. Magnesium sulfate loading: preeclampsia vs preterm labor (a clinical pearl) AVOD was found to be similar in preeclamptic and preterm labor patients. A 4 g loading dose of MgSO4 is usually adequate to achieve therapeutic levels in preeclampsia but not in preterm labor. AVOD was found to be similar in preeclamptic and preterm labor patients.

Magnesium Sulfate offers two benefits in the case of preterm labor – stopping contractions and reducing the incidence of cerebral palsy in babies. Magnesium sulfate and other tocolytic medications are often used to stop labor long enough for the administration of corticosteriods before birth. If Magnesium Sulfate is given for treatment of preterm labor, the woman should be informed that the efficacy and safety of such use have not been established and that use of Magnesium Sulfate beyond 5-7 days may cause fetal abnormalities.

Parenteral use in the presence of renal insufficiency may lead to magnesium intoxication. Mittendorf R, Dambrosia J, Pryde PG, Lee KS, Gianopoulos JG, Besinger RE, et al. Association between the use of antenatal magnesium sulfate in preterm labor and adverse health outcomes in infants. Am J Obstet Gynecol 2002;186:1111–8. Magnesium Sulfate: A drug that may help prevent cerebral palsy when it is given to women in preterm labor who may deliver before 32 weeks of pregnancy.

Neonatal Intensive Care Unit (NICU): A special part of a hospital in which sick newborns receive medical care.

List of related literature:

Magnesium sulfate (MgSO4) is commonly used as an anticonvulsant for toxemia and as a tocolytic agent for premature labor during the last half of pregnancy.

“Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk” by Gerald G. Briggs, Roger K. Freeman, Sumner J. Yaffe
from Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk
by Gerald G. Briggs, Roger K. Freeman, Sumner J. Yaffe
Wolters Kluwer Health/Lippincott Williams & Wilkins, 2011

Magnesium sulfate for preventing preterm birth in threatened preterm labor.

“Practical Guide to High Risk Pregnancy and Delivery E-Book” by Fernando Arias, Amarnath G Bhide, Arulkumaran S, Kaizad Damania, Shirish N Daftary
from Practical Guide to High Risk Pregnancy and Delivery E-Book
by Fernando Arias, Amarnath G Bhide, et. al.
Elsevier Health Sciences, 2012

The use of magnesium sulfate as a tocolytic agent or as a treatment for preeclampsia may precipitate a myasthenic crisis and is contraindicated.

“Neurology in Clinical Practice: The neurological disorders” by Walter George Bradley
from Neurology in Clinical Practice: The neurological disorders
by Walter George Bradley
Butterworth-Heinemann, 2004

Magnesium sulphate for preventing preterm birth in threatened preterm labour.

“Volpe's Neurology of the Newborn E-Book” by Joseph J. Volpe, Terrie E Inder, Basil T. Darras, Linda S. de Vries, Adre J du Plessis, Jeffrey Neil, Jeffrey M Perlman
from Volpe’s Neurology of the Newborn E-Book
by Joseph J. Volpe, Terrie E Inder, et. al.
Elsevier Health Sciences, 2017

Magnesium sulfate use for preterm labor tocolysis is considered “off-label.”

“Perinatal Nursing” by Kathleen Rice Simpson, Patricia A. Creehan, Association of Women's Health, Obstetric, and Neonatal Nurses
from Perinatal Nursing
by Kathleen Rice Simpson, Patricia A. Creehan, Association of Women’s Health, Obstetric, and Neonatal Nurses
Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008

magnesium sulfate in preterm labor and adverse health outcomes in infants.

“Obstetrics: Normal and Problem Pregnancies E-Book” by Mark B Landon, Henry L Galan, Eric R. M. Jauniaux, Deborah A Driscoll, Vincenzo Berghella, William A Grobman, Sarah J Kilpatrick, Alison G Cahill
from Obstetrics: Normal and Problem Pregnancies E-Book
by Mark B Landon, Henry L Galan, et. al.
Elsevier Health Sciences, 2020

Uses Magnesium sulfate is used in obstetrics to inhibit premature labor.

“Clayton's Basic Pharmacology for Nurses” by Michelle Willihnganz, Samuel L Gurevitz, Bruce D Clayton
from Clayton’s Basic Pharmacology for Nurses
by Michelle Willihnganz, Samuel L Gurevitz, Bruce D Clayton
Elsevier Health Sciences, 2019

Magnesium sulfate is used in pregnancy-induced hypertension.

“Pharmacology and the Nursing Process E-Book” by Linda Lane Lilley, Shelly Rainforth Collins, Julie S. Snyder
from Pharmacology and the Nursing Process E-Book
by Linda Lane Lilley, Shelly Rainforth Collins, Julie S. Snyder
Elsevier Health Sciences, 2019

Tocolytics include magnesium sulfate and/or beta-2 agonists, which relax the uterine smooth muscle and decreased contractions.

“Trauma: Emergency Resuscitation, Perioperative Anesthesia, Surgical Management, Volume I” by William C. Wilson, Christopher M. Grande, David B. Hoyt
from Trauma: Emergency Resuscitation, Perioperative Anesthesia, Surgical Management, Volume I
by William C. Wilson, Christopher M. Grande, David B. Hoyt
CRC Press, 2007

The expected outcome of magnesium sulfate administration is suppression of the contractions because the client is in preterm labor.

“Lippincott Q&A Review for NCLEX-RN” by Diane Billings, Desiree Hensel
from Lippincott Q&A Review for NCLEX-RN
by Diane Billings, Desiree Hensel
Wolters Kluwer Health, 2016

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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  • Brilliant and useful. I am an internist doing critical care hospitalist work and study OB to be ready for the dreaded call…we use magnesium for cardiac dysrhythmias all the time. Train hard, fight easy!