The Effects of Magnesium Sulfate Infusion on Blood Pressure and Vascular Responsiveness During Pregnancy

Lee, M. I.; Todd, H.; Bowe, Andrea

doi:10.1097/00132586-198508000-00019

Cited by 3 publications

(4 citation statements)

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“…Magnesium sulphate, infused intravenously at a dose (3 g) which had no effect per se on arterial blood pressure when injected in normotensive animals, attenuated the noradrenaline‐induced cerebral vasoconstrictor and pressor responses and increased cerebral blood flow. The results on the effect of magnesium sulphate on arterial blood pressure are in agreement with those obtained previously in rabbits 23 and rats 24 , and suggest that Mg 2+ could be used as a primary antihypertensive agent. In fact, a significant fall in arterial blood pressure has been shown after magnesium sulphate infusion in hypertensive patients 25,26 .…”

Section: Discussionsupporting

confidence: 91%

Effects of magnesium sulphate on the noradrenaline‐induced cerebral vasoconstrictor and pressor responses in the goat

Perales¹,

Torregrosa²,

Salom³

et al. 1997

BJOG

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Objective To examine the ability of magnesium sulphate to counteract the noradrenaline-induced cerebral vasoconstrictor and pressor responses in goats by using both in vivo and in vitro techniques.Design Cerebral blood flow was measured in vivo by means of an electromagnetic flow probe around the internal maxillary artery. Isometric tension was recorded in vitro from rings of goat middle cerebral artery maintained in an organ bath.1. In vivo. Continuous inhsion of noradrenaline (10 pg/min) directly into the cerebral arterial supply elicited sustained decrease in cerebral blood flow (61% [SEM 31 of control values) and increase in cerebral vascular resistance (178% [SEM 91 of control values). Magnesium sulphate, injected directly into the cerebral arterial supply (10-300 mg) or infused intravenously (0.3 g and 3 g during 15 min) at the noradrenaline-induced steady state, increased cerebral blood flow by decreasing cerebral vascular resistance in a dose-dependent manner. A similar result was obtained when intravenous magnesium sulphate (3 g/l5 min) was tested against the cerebral vasoconstrictor and pressor responses induced by intravenous infusion of noradrenaline (30 pglmin Conclusions Magnesium sulphate reverses the noradrenaline-induced cerebral vasoconstrictor and pressor responses by a direct inhibitory action of Mg2+ on the actions of noradrenaline in the cerebral and peripheral vascular beds, which leads to a decrease in vascular resistance. These results could explain, at least in part, the beneficial effects of magnesium sulphate in the management of preeclampsia and eclampsia.

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Section: Discussionsupporting

confidence: 91%

Effects of magnesium sulphate on the noradrenaline‐induced cerebral vasoconstrictor and pressor responses in the goat

Perales¹,

Torregrosa²,

Salom³

et al. 1997

BJOG

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“…19 Parity and the use of magnesium sulfate may also influence cardiovascular response to therapy during pregnancy. [68][69][70] Prediction models can be created from clinical data at presentation to identify patients who will and will not have a sustained response to intravenous hydralazine and labetalol. 27 The incorporation of pharmacogenetics into clinical practice starts from the observation of different efficacies of medications in those of various racial descent.…”

Section: Discussionmentioning

confidence: 99%

“…It is equally important for the major guideline groups to promote the concept of heterogeneity in response to medications, and provide BP treatment algorithms that take into account patient‐specific conditions such as race, age, and the presence of obesity and other comorbidities, while making a choice of first‐ and second‐line agents for secondary prevention issues 19 . Parity and the use of magnesium sulfate may also influence cardiovascular response to therapy during pregnancy 68‐70 . Prediction models can be created from clinical data at presentation to identify patients who will and will not have a sustained response to intravenous hydralazine and labetalol 27 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Experiences of Intravenous Hydralazine and Labetalol for Acute Treatment of Severe Hypertension in Pregnant Thai Women

Chera-aree

Tengtrakulcharoen

Leetheeragul

et al. 2020

The Journal of Clinical Pharma

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Response to acute treatment of severe hypertension during pregnancy in Asian women was not known. Labor and delivery checklists of Thai women treated with intravenous hydralazine or labetalol for systolic blood pressure (SBP) ≥ 160 or diastolic blood pressure (DBP) ≥ 110 mm Hg from January 2011 to December 2013 were reviewed as parts of an audit. Primary outcome was prompt achievement of SBP 140-150 and DBP 90-100 mm Hg after the first bolus. Secondary outcomes were medication-related undesired effects. The mean ± standard deviation age and prevalence of chronic hypertension in hydralazine (n = 62) versus labetalol (n = 64) groups were 32.5 ± 6 versus 29.9 ± 6.8 years and 50% versus 21.9%, respectively (P < .05). Magnesium sulfate was promptly administered on admission to every woman to prevent seizure. Targeted blood pressure was timely achieved in 41.9% and 67.2% of the hydralazine and labetalol groups, respectively (P < .05). Nonreassuring fetal heart rate occurred in 51.6% and 32.8% of the hydralazine and labetalol groups, respectively (P = .05). The prevalence of cesarean section and Apgar score < 7 were not significantly different (P > .05). Real-life clinical experiences suggested significant advantages of intravenous labetalol over hydralazine in pregnant women with severe hypertension.

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“…5 If there were dangerous increases in blood pressure during contractions, they would be ignored if measurements were taken only between contractions. MgSO 4 has been shown to attenuate the pres-sor response to catecholamines in the rabbit model 6 ; it seems reasonable to hypothesize that it might obtund the rise in blood pressure during contractions in humans.…”

mentioning

confidence: 98%

Pre-Eclampsia, Magnesium Sulfate, and Blood Pressure Evaluation During Labor: A Preliminary Consideration

Bhatia¹,

Bottoms²,

Sokol³

1987

Amer J Perinatol

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The influences of uterine contractions and magnesium sulfate (MgSO4) infusion on blood pressure evaluation of the pre-eclamptic patient in labor have not been thoroughly investigated. Blood pressures were measured between and during contractions in 13 patients with pre-eclampsia, before and after MgSO4, and in 17 normotensive patients. Pre-eclampsia was associated with a mean 11 mm Hg increase in pulse pressure (P less than 0.001), which fell by 8 mm Hg following MgSO4 infusion (P less than 0.001). With pre-eclampsia, pressure increases up to 45/28 mm Hg were observed during contractions. Theoretically, reduced pulse pressure, resulting in decreased shearing force applied to vessel walls, could be a previously unrecognized therapeutic effect of MgSO4. Potentially dangerous pressure elevations could be missed by relying exclusively on diastolic values measured between contractions.

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The Effects of Magnesium Sulfate Infusion on Blood Pressure and Vascular Responsiveness During Pregnancy

Cited by 3 publications

References 0 publications

Effects of magnesium sulphate on the noradrenaline‐induced cerebral vasoconstrictor and pressor responses in the goat

Effects of magnesium sulphate on the noradrenaline‐induced cerebral vasoconstrictor and pressor responses in the goat

Clinical Experiences of Intravenous Hydralazine and Labetalol for Acute Treatment of Severe Hypertension in Pregnant Thai Women

Pre-Eclampsia, Magnesium Sulfate, and Blood Pressure Evaluation During Labor: A Preliminary Consideration

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