Alternative magnesium sulphate regimens for women with pre-eclampsia and eclampsia

Diaz, Virginia; Long, Qian; Oladapo, Olufemi T

doi:10.1002/14651858.cd007388.pub3

Cited by 5 publications

(1 citation statement)

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“…The pharmacological effects of different types of magnesium salts are specific to treating a wide range of diseases and symptoms. For instance, magnesium sulfate is predominantly utilized in obstetrics for the prevention of seizures in pre-eclampsia and recurrence in eclampsia ( 1 , 2 ). It also acts as a neuroprotective agent in cases of preterm labor and in critically ill patients to manage severe hypomagnesemia ( 3–6 ).…”

Section: Introductionmentioning

confidence: 99%

Case report: Near-fatal hypermagnesemia resulting from the use of Epsom salts in a patient with normal renal function

Si,

Ge,

et al. 2024

Front. Med.

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Hypermagnesemia commonly occurs in patients with renal dysfunction. Diagnosing hypermagnesemia represents a challenge due to its rarity and the absence of routine monitoring of magnesium levels. Furthermore, the lack of awareness among clinicians regarding this uncommon condition frequently leads to delayed diagnoses. Few patients survive with a serum magnesium level exceeding 7 mmol/L. This article presents a case study of near-fatal hypermagnesemia resulting from the oral administration of Epsom salts in a patient with normal renal function. A 60-year-old female presented to the gastroenterology department on Oct. 6, 2023, with a 3-day history of black stools. She underwent subtotal gastrectomy in 2005 and has a stable history of nephrotic syndrome. To investigate the cause of her bleeding, electronic gastroscopy and colonoscopy were scheduled for Oct. 11, 2023. She experienced a sudden loss of consciousness 30 min after the ingestion of Epsom salts. The attending physician suspected a severe magnesium poisoning. She was promptly administered calcium gluconate, underwent tracheal intubation with ambu bag ventilation, and received early continuous renal replacement therapy (CRRT). Swift diagnosis and CRRT contributed to a reduction in her serum magnesium levels from an initial 8.71 mmol/L to 1.35 mmol/L, leading to a remarkable improvement in the toxic symptoms associated with hypermagnesemia. Subsequently, she was managed in the gastroenterology department, with gastroscopy revealing bleeding from the gastrointestinal anastomotic ulcer. Following conservative treatments including acid suppression, stomach protection, and hemostasis, her symptoms improved, and she was successfully discharged. This study aims to alert clinicians to the possibility of hypermagnesemia in individuals with normal renal function. Physicians should exercise caution when prescribing Epsom salts to patients with underlying gastrointestinal conditions. If necessary, alternative drug therapies may be considered to mitigate the risk of hypermagnesemia. Timely intervention is pivotal in averting life-threatening complications linked to hypermagnesemia.

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Section: Introductionmentioning

confidence: 99%

Case report: Near-fatal hypermagnesemia resulting from the use of Epsom salts in a patient with normal renal function

Si,

Ge,

et al. 2024

Front. Med.

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Evidence-based obstetric guidance in the setting of a global intravenous fluid shortage

Heerboth,

Devlin,

Benipal

et al. 2024

American Journal of Obstetrics & Gynecology MFM

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Investigation into the Role of Forkhead Box A1 (FOXA1) in Late-Onset Preeclampsia of a Prospective Cohort Study and Its Actions on Trophoblast Invasion and Migration

Zhu,

Wei,

Wang

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Background: The primary objective was to investigate how Forkhead Box A1 (FOXA1) contributes to late-onset preeclampsia (LOPE) and its impact on trophoblast invasion and migration. Methods: The prospective cohort study included 15 pregnant women with LOPE (gestational age of ≥34+0 weeks), and 18 normal pregnant women. FOXA1 expression in placental tissues was determined by immunofluorescent and immunohistochemical (IHC) staining. FOXA1 mRNA and protein expression in HTR-8/SVneo was determined by real-time quantitative polymerase chain reaction (qPCR) and western blot, respectively. Flow cytometry was utilized to analyze cell apoptosis/cycle of HTR-8/SVneo cells. Additionally, the Transwell/wound healing assays were employed to assess invasion/migration of HTR-8/SVneo cells. Student’s t-test was employed to compare measurement data of normal distribution between two groups. Results: In placental tissues of women with LOPE, FOXA1 exhibited downregulation when compared to the normal controls. No significant differences were observed in pregnancy duration, maternal age, delivery times, or 1- and 5-minute Apgar scores between the two groups. However, the LOPE group had a significantly shorter gestational week at delivery, higher systolic and diastolic blood pressure, the presence of 24-hour proteinuria, lower neonatal birth weight, and lower placental weight. FOXA1 overexpression altered the cell cycle of trophoblasts, increasing the population in the S phase and decreasing it in the G2/M phase, with no effect on the G0/G1 phase. It did not affect trophoblast apoptosis. Furthermore, FOXA1 overexpression enhanced trophoblast invasive ability and migration. However, FOXA1 overexpression did not affect the mRNA expression levels of N-cadherin, vimentin, and fibronectin in trophoblast cells. Conclusions: In summary, our findings indicate that FOXA1 was underexpressed in the placental tissues of women with LOPE. Furthermore, the overexpression of FOXA1 led to significant changes in the trophoblast cell cycle and substantially enhanced trophoblast invasion and migration capabilities.

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Alternative magnesium sulphate regimens for women with pre-eclampsia and eclampsia

Cited by 5 publications

References 84 publications

Case report: Near-fatal hypermagnesemia resulting from the use of Epsom salts in a patient with normal renal function

Case report: Near-fatal hypermagnesemia resulting from the use of Epsom salts in a patient with normal renal function

Evidence-based obstetric guidance in the setting of a global intravenous fluid shortage

Investigation into the Role of Forkhead Box A1 (FOXA1) in Late-Onset Preeclampsia of a Prospective Cohort Study and Its Actions on Trophoblast Invasion and Migration

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