High and low dose intravenous magnesium sulfate for tocolysıs: A comparative study

Amaç To compare the effects of a high dose protocol for magnesium sulphate tocolytic therapy with a low dose regimen with respect to time needed to achieve tocolysis, the effects on the biophysical profile and fetal heart rate. Materials-

Yöntem

Patients, between 28 and 34 weeks' gestation with preterm labor, were prospectively randomly assigned to receive two different protocols. For low dose regimen 2 g/h magnesium sulphate was administered to 25 patients and in high dose protocol 24 patients received 4 g loading dose followcd by a continuous infusion of 2 g/h. Biophysical profile examinations were performed at admission and at 1 and 6 hours of tocolytic therapy. The fetal heart rate tracing for 30 minutes was used to determine fetal heart rate reactivity before each biophysical profile. Statistical analyses were performed and statistical significance was set at p<0.05.

Bulgular

Although, no statistical significant difference was found between the two regimens when compared for tocolytic effectiveness (p=0.463). time needed to achieve tocolysis was significantly shorter in high dose regimen (p=0.006). Significantly altered biophysical profile was observed in high dose regimen (p<0.05) at first hour of tocolysis, different from low dose regimen. There was a significant reduction in total biophysical profile score (p<0.05) and basal fetal heart rate (p<0.001) at 6.h in fetuses exposed to both low and high dose magnesium sulphate. No statistically significant difference was found in short-term variability 6 hours after initiation of therapy when two regimens are compared (p=0.24).

Sonuç

Low dose intravenous magnesium sulphate for tocolysis is recommended due to late-onset of adverse effects and equivalent tocolytic effect when compared to high dose protocol. However, obstetricians should bear in mind that magnesium sulphate alters biophysical profile and is associated with decreased basal fetal heart rate.

Anahtar Kelimeler

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