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

PE Bouet, S Brun, H Madar, AL Baisson, V Courtay… - Scientific Reports, 2015 - nature.com
PE Bouet, S Brun, H Madar, AL Baisson, V Courtay, G Gascoin-Lachambre, S Lasocki
Scientific Reports, 2015nature.com
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 …
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.
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