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Magnesium sulfate is effective in decreasing the risk that pre-eclampsia progresses to eclampsia. [24] Intravenous magnesium sulfate is used to prevent and treat seizures of eclampsia. It reduces the systolic blood pressure but does not alter the diastolic blood pressure, so the blood perfusion to the fetus is not compromised.
[15] [41] During pregnancy brisk or hyperactive reflexes are common, however, ankle clonus is a sign of neuromuscular irritability that usually reflects severe pre-eclampsia and also can precede eclampsia. [93] Magnesium sulfate is used to prevent convulsions in cases of severe pre-eclampsia.
It is typically caused by kidney failure or is treatment-induced such as from antacids or supplements that contain magnesium. [1] [6] Less common causes include tumor lysis syndrome, seizures, and prolonged ischemia. [2] Diagnosis is based on a blood level of magnesium greater than 1.1 mmol/L (2.6 mg/dL).
Magnesium sulfate infusion for 24–48 hours to allow maximum efficacy of corticosteroids for fetal lungs and also confer benefit to fetal brain and gut before delivery; One time dose of corticosteroids (two separate administrations, 12–24 hours apart) before 34 weeks; Antibiotics if needed to prevent GBS transmission; Pre-viable < 24 weeks
The study demonstrating the effectiveness of magnesium sulfate for the management of eclampsia was first published in 1955. [57] Effective anticonvulsant serum levels range from 2.5 to 7.5 mEq/L, [ 58 ] however the ideal dosing regime (dose, route of administration, timing of dosing) to prevent and treat eclampsia is not clear.
As a bronchodilator after beta-agonist and anticholinergic agents have been tried, e.g. in severe exacerbations of asthma. [4]Obstetrics: Magnesium sulfate is used to prevent seizures in women with preeclampsia and eclampsia, and is also used for fetal neuroprotection in preterm deliveries, but has been shown to be an ineffective tocolytic agent.
Magnesium sulfate [40] Myosin light chain inhibitor Probably effective in delaying preterm birth by 48 hours. [8] It is used for its neuro-protective effects since it is shown to decrease the risk of cerebral palsy in infants. [41] Absolute contraindication: myasthenia gravis. [42] Use as a tocolytic agent may result in death of the fetus or ...
In pregnant patients where there is concern for pre-eclampsia, patients should be given magnesium sulfate and admitted. Urine output, breathing, and reflexes should be monitored closely with concern for the development of worsening kidney function and magnesium toxicity. Systolic blood pressure should be treated with antihypertensive ...