Maternal Intravenous MgSO4 Administration and Its Effects on Neonatal Respiratory Function and Risk of Development of Hemodynamically Significant Patent Ductus Arteriosus Shunts During the Initial 72 Hours of Life

Document Type

Conference Proceeding

Publication Date

1-1-1999

Description

Tocolytic therapy with MgSO4 is well-tolerated with a low incidence of significant maternal side effects. There is evidence, however, that Mg++ accumulates in amniotic fluid with prolonged tocolysis, defined as > 72 hrs. Fetal swallowing of AF may account for the persistently higher levels seen. Objectives of this project were to track serum Mg++ levels among mothers admitted to the LandD Suite of the Johnson City Medical Center Hospital who required IV MgSO4 therapy > or < 72 hrs for control of pre-eclampsia or premature labor and who deliver their neonates while receiving such therapy. Neonatal Mg++ and Ca++ levels were obtained and infants followed for development of clinical signs and echocardiographic evidence of hsPDA with left to right shunts during the initial 72° life. Data collected between 11/95 to 9/98. Infants were divided into 3 groups: controls; IV MgSO4 exposure < 72° prior to delivery; and IV MgSO4 exposure > 72° prior to delivery. 36/102 (36%) control infants, 42/159 (26%) < 72° exposed infants and 20/36 (56%) infants > 72° exposure prior to delivery. parameter controls IV MgSO4 < 72° IV MgSO4 > 72°# 36 42 20 Birthweight 1296.2 (464-3330) 1024.0 (456-3219) 1021.6 (527-1715) Gestational Age 28.4 (23-36) 28.2 (22-33) 27.9 (24-33) Patients with hspdas (11/95-9/98) Results to date indicate higher average Mg++B among infants exposed to maternal MgSO4 > 72° than among those infants exposed < 72° or controls. Incidence of hsPDAs requiring indocin IV therapy > 2:1 (> 72° group vs < 72° group) without significant differences among BW or GA suggesting a ductal musculature relaxing effect resulting in a higher incidence of hsPDAs requiring indocin therapy.

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