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Commonly used tocolytic medications include β 2 agonists, calcium channel blockers, NSAIDs, and magnesium sulfate. These can assist in delaying preterm delivery by suppressing uterine muscle contractions and their use is intended to reduce fetal morbidity and mortality associated with preterm birth. [ 2 ]
Magnesium sulfate acts as a vasodilator, reducing vascular resistance and protect the blood-brain barrier (BBB). The goal of these treatments is to prolong pregnancy and increase fetal survival. Each day gained by treatment in utero increases fetal survival and intact survival by 1%–2% up to 28 weeks gestation.
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.
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.
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 is used often in patients with preeclampsia and eclampsia, can inadvertently inhibit uterine contractions. In addition, preeclampsia can lead to blood disorders such as thrombocytopenia, platelet abnormalities, and disseminated intravascular coagulation. [5]
Magnesium sulfate or magnesium sulphate is a chemical compound, a salt with the formula MgSO 4, consisting of magnesium cations Mg 2+ (20.19% by mass) and sulfate anions SO 2− 4. It is a white crystalline solid , soluble in water but not in ethanol .