Implementation of an antenatal magnesium sulfate protocol for fetal neuroprotection in preterm infants

Sci Rep. 2015 Sep 29:5:14732. doi: 10.1038/srep14732.

Abstract

The aim of our study was to assess the feasibility of implementing a protocol for the use of magnesium sulfate to prevent cerebral palsy. This retrospective single-center study included all women with fetuses of gestational age <33 weeks of gestation whose birth was planned or expected within 24 hours from September 2011 to December 2012. They were to receive magnesium sulfate, administered intravenously as a 4-g bolus followed by a constant infusion of 1 g per hour. If delivery had not occurred after 12 hours and was no longer considered imminent, the infusion was to be discontinued. The study included 119 women, 81 (68.1%) of whom received magnesium sulfate. Among the latter, 71 (87.5%) gave birth within 24 hours. The reasons treatment was not given were: omission by medical team (19/38, 50%), urgent delivery (18/38, 47.4%), and contraindication to treatment (1/38, 2.6%). The mean gestational age at protocol implementation was 29.6 +/- 2.1 weeks. Maternal monitoring, especially at the onset of infusion, appeared suboptimal. No major maternal side effects were observed. Our study shows that implementing a protocol for prevention of cerebral palsy by magnesium sulfate is feasible in a tertiary obstetric center.

MeSH terms

  • Adult
  • Cerebral Palsy / physiopathology
  • Cerebral Palsy / prevention & control*
  • Drug Administration Schedule
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Magnesium Sulfate / therapeutic use*
  • Monitoring, Physiologic
  • Neuroprotective Agents / therapeutic use*
  • Obstetric Labor, Premature / physiopathology*
  • Pregnancy
  • Retrospective Studies
  • Tertiary Care Centers

Substances

  • Neuroprotective Agents
  • Magnesium Sulfate