11717

Using of Magnesium Sulphate for Fetal Neuroprotection in Patients Presenting by Intrapartum Fetal Distress at Term: A Randomized Controlled Trial

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Last updated: 03 Jan 2025

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Abstract

Background: labour is a stressful event for the fetus but is well tolerated by most fetuses. However, in some infants stress of labour in terms of metabolic acidosis can lead to Hypoxic Ischemic Encephalopathy (HIE). HIE around term remains a major cause of neonatal mortality and morbidity with lifelong chronic disabilities. Such insults are not limited to high risk pregnancies but can also occur in about 50% of low risk pregnancies. On current evidence, it is estimated that in about 10 of brain damaged infants, the cause is hypoxia during labour.There has been considerable interest in magnesium sulfate (MgSO4) because magnesium alleviates excitotoxic damage by binding to the magnesium site on the NMDA (N-methyl-D-aspartate) glutamate channel. Aim of the Work: magnesium sulphate (MgSo4) for fetal neuroprotection in patients presenting by intrapartum fetal distress at term. Patient and Methods:this is a randomized controlled trial (RCT). The current study was conducted to single term pregnant women who developed intrapartum fetal distress (as defined later) and need emergency CS (ceaseran section) according to Ain Shams protocol. This study was carried on 200 pregnant females, recruited from observation and labour wards of Ain Shams University Maternity Hospital. The current study was conducted to single term 200pregnant women who developed intrapartum fetal distress and needs emergency CS (cesarean section) according to Ain Shams protocoltoexaminethe effects of administered magnesium sulphate .patient were invited to participate in the study after providing clear explanation of the study and its expected values. Result: patients were invited to participate in this study after providing clear explanation of the study and its expected values. The demographic data of included women showed no significant difference between groups in the age and gestational age There was a significant difference in Apgar score at 5 min between MgSo4 and placebo.MgSo4 had significantly lower the risk of decrease Apgar score < 7 at 5min(p:0.029) .Mgso4 also had significantly lower seizure attacks (p:0.002) and had highly significantly reduce NICU admission rate (MgSo4 group 20(20%) and placebo group 43(43%)(p: 0.001)).In MgSo4 group, 23 women reported adverse reactions associated with procedure. Among them, 16 (16%) reported only flushing and 7 (7%) reported only nausea. In placebo group, were 8 (8%) reported flushing and 2 (2%) reported nausea. Conclusion and Recommendation: magnesium sulfate is effective in reducing risk of Apgar score <7 at 5min. Magnesium sulfate appear to be effective in reducing seizure and NICU admission. Magnesium sulphate is associated with maternal morbidity rather than non exposure in the form of nausea and flushing. The improvement in short-term outcomes without significant increase in side effects indicate the need for further trials to determine if there are long-term benefits of magnesium and to confirm its safety.  

DOI

10.12816/0040605

Keywords

Magnesium sulphate, Fetal Neuroprotection, Intrapartum Fetal Distress, cesarean section

Authors

First Name

Amr Abdel-Aziz Mahmoud

Last Name

Nadim

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Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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First Name

Ahmad ElSayed Hassan

Last Name

ElBohoty

MiddleName

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Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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First Name

Reda Mokhtar Kamal

Last Name

Ghanem

MiddleName

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Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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Orcid

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First Name

Fatma Mohamed

Last Name

Mahmoud

MiddleName

-

Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University

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Volume

69

Article Issue

2

Related Issue

2165

Issue Date

2017-10-01

Receive Date

2018-08-27

Publish Date

2017-10-01

Page Start

1,794

Page End

1,802

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_11717.html

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https://ejhm.journals.ekb.eg/service?article_code=11717

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4

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Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Using of Magnesium Sulphate for Fetal Neuroprotection in Patients Presenting by Intrapartum Fetal Distress at Term: A Randomized Controlled Trial

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Article

Created At

22 Jan 2023