Intrapartum magnesium sulfate is associated with neuroprotection in growth-restricted fetuses

Stockley, Elizabeth; Ting, Joseph; Kingdom, John; McDonald, Sarah D.; Barrett, Jon; Synnes, Anne; Monterrosa, Luis; Shah, Prakesh S.

doi:10.1016/j.ajog.2018.09.010

Cited by 17 publications

(8 citation statements)

References 35 publications

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“…It is a lifesaving drug, which slows neuromuscular conduction and decreases the central nerves system irritability by triggering cerebral vasodilation, thus reducing ischemia generated by cerebral vasospasm during an eclamptic event [ 20 ]. The advantages of using MgSO4 as drug of choice are not only limited to prevent primary and recurrent maternal seizures; but it reduces maternal and perinatal mortality and morbidity in pregnant women with pre-eclampsia and eclampsia [ 20 – 22 ]. It plays a role of neuroprotection by reducing the risk of cerebral palsy in grow-restricted foetus and preterm below 30 weeks of gestation [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of using MgSO4 as drug of choice are not only limited to prevent primary and recurrent maternal seizures; but it reduces maternal and perinatal mortality and morbidity in pregnant women with pre-eclampsia and eclampsia [ 20 – 22 ]. It plays a role of neuroprotection by reducing the risk of cerebral palsy in grow-restricted foetus and preterm below 30 weeks of gestation [ 21 , 22 ]. In Kenya, MgSO4 is an essential medication available at all different levels of care.…”

Section: Discussionmentioning

confidence: 99%

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Maternal and perinatal outcomes in women with eclampsia by mode of delivery at Riley mother baby hospital: a longitudinal case-series study

Irene

Amubuomombe

Mogeni

et al. 2021

BMC Pregnancy Childbirth

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Background Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Maternal and perinatal outcomes in women with eclampsia by mode of delivery at Riley mother baby hospital: a longitudinal case-series study

Irene

Amubuomombe

Mogeni

et al. 2021

BMC Pregnancy Childbirth

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“…There is good evidence for the efficacy of magnesium sulfate for fetal neuroprotection in the context of preterm delivery, however, the exact gestational-age threshold at which this attenuates remains unclear 77 . Many guidelines and studies recommend magnesium sulfate prophylaxis for neuroprotection in growth-restricted fetuses, though the suggested time of commencement varies, being < 32-33 weeks 73 , < 32 weeks 70,72 , < 30 weeks 78 or < 29 weeks' gestation 79 . In the absence of strong evidence regarding the optimum gestational age of magnesium sulfate prophylaxis that would allow for uniform application among countries, we recommend to refer to local or national guidelines.…”

Section: Magnesium Sulfate Prophylaxismentioning

confidence: 99%

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

Lees

Stampalija

Baschat

et al. 2020

Ultrasound in Obstet & Gyne

491

454

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ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction Clinical Standards CommitteeThe International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, and high-quality teaching and research related to diagnostic imaging in women's healthcare. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach, from experts, for diagnostic imaging. They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts any liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. The ISUOG CSC documents are not intended to establish a legal standard of care, because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances, local protocol and available resources. Approved Guidelines can be distributed freely with the permission of ISUOG (

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“…Antenatal steroids are recommended for promoting fetal lung maturity [ 10 ]. Intrapartum administration of magnesium sulfate to mothers with IUGR infants born before 29 weeks gestation is also shown to decrease the odds of composite death or significant neurodevelopmental impairment [ 11 ]. Taking these factors into consideration is critical in the optimal management of IUGR pregnancies to prevent adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Growth Restriction and Placenta Previa: A Clinical Case Report of an Advanced-Age Pregnancy

Patibandla,

Ansari,

Brown

2024

Cureus

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Exploring the intricacies of managing high-risk pregnancies complicated by intrauterine growth restriction (IUGR), placenta previa, and a single umbilical artery requires a comprehensive understanding of their etiologies, mechanisms, and treatment recommendations. This case report delves into the clinical course of a 34-year-old smoker with a pre-pregnancy body mass index of 14.2 kg/m 2 , shedding light on the considerations posed by a pregnancy in which several risk factors are superimposed on one another. IUGR, affecting 10%-15% of pregnancies, elevated the risk of adverse outcomes during labor and delivery, necessitating careful antenatal monitoring. Placenta previa, with an incidence of 0.3% to 2% in pregnancies, introduced further complications impacting delivery modes and raising the risk of hemorrhage. This report aims to showcase the interconnectedness between these various obstetrical complications and risk factors, to guide maternal-fetal-medicine specialists in making informed decisions during the management of high-risk pregnancies.

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Intrapartum magnesium sulfate is associated with neuroprotection in growth-restricted fetuses

Abstract: Intrapartum administration of magnesium sulfate to women with growth-restricted fetuses born <29 weeks' gestation was associated with reduced odds of composite of death or significant neurodevelopmental impairment.

Cited by 17 publications

References 35 publications

Maternal and perinatal outcomes in women with eclampsia by mode of delivery at Riley mother baby hospital: a longitudinal case-series study

Maternal and perinatal outcomes in women with eclampsia by mode of delivery at Riley mother baby hospital: a longitudinal case-series study

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

Intrauterine Growth Restriction and Placenta Previa: A Clinical Case Report of an Advanced-Age Pregnancy

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