PERINATOLOGIYA I PEDIATRIYA.2015.3(63):18-22; doi 10.15574/PP.2015.63.18 
 

Intranatal administration of magnesium sulfate 4 obstetric point of view on perinatal outcomes 
 

Zagorodnyaya A. S., Belaya V. V., Leush S. St.

A.A. Bogomolets National Medical University, Kyiv, Ukraine

Kyiv Perinatal Center, Ukraine 
 

Objective: to evaluate the effect of magnesia intranatal therapy on neonatal mortality, rate of major complications of neonatal period and the development of extremely premature infants within the first 2 years. 
 

Patients and methods. The study included 187 pregnant women in the I period of preterm birth. Pregnant women were divided into 2 groups: group I (90 patients) received a standard set of medical care; group II (97 women) in addition to standard therapy in birth had received magnesium sulfate by the proposed scheme. The total dose of magnesium sulfate was 8 g of dry substance. Among the 187 infants was studied average Apgar score, the rate of early and late neonatal mortality, intraventricular hemorrhage and degree of their severity. After examination once a month for 2 years has been assessed infant development by Beyli scale. For statistical evaluation of the differences between the groups was used Fisher's test with determination the reliability by Student's coefficient (considered reliable differences when p < 0.05), and for confirmation of the quantitative differences between the groups was used Kolmogorov-Smirnov's criteria (groups considered to be heterogeneous if a_empіr>a_crit). 
 

Results. Intranatal use of magnesium sulfate by the proposed scheme does not alter the Apgar score at birth, by other words, not adversely affected on breathing and reflexes. A tendency for decreasing of the frequency of intraventricular hemorrhage and changes in their structure with a predominance of lighter forms is shown. The dynamics of the preterm infants development by Beyli scale, especially more rapid achievement of the level of healthy peers by those patients who received intranatal magnesian therapy in order to neuroprotection is demonstrated. 
 

Conclusions. Application of intranatal magnesian therapy allows effectively reduce the severity of intracranial hemorrhage and improves neuropsychological development of extremely premature infants and to a more rapid achievement of indicators of term infants. 
 

Key words: magnesium sulfate, neuroprotection, intraventricular hemorrhage, Beyli scale. 
 

REFERENCES

1. Венцківська ІБ, Біла ВВ, Леуш ССт та ін. 2013. Нові погляди на застосування магнію сульфату в акушерстві. Неонатологія, хірургія та перинатальна медицина. ІІІ;4: 81—84.

2. Мурзалиев А, Шлиффер С, Исмаилова Г, Эрикбаева Н, Фирсова М. 2003. О нейропротективном действии магния сульфата при ишемии головного мезга. Вестник КРСУ. 7: 12—18.

3. Про затвердження клінічних протоколів з акушерства та гінекології «Передчасні пологи». Наказ МОЗ України від 03.11.2008 р. № 624. www.moz.gov.ua.

4. Сулима ЕГ, Эфендеева ГБ. 2007. Частота внутрижелудочковых кровоизлияний у недоношенных новорожденных в акушерских стационарах. Матер наук-практ конф з міжнародною участю «Фізіологія та патологія новонароджених». Київ: 158—162.

5. Nassar A, Sakhel K, Maarouf H, Naassan G, Usta I. 2006. Adverse maternal and neonatal outcome of prolonged magnesium sulfate tocolysis. Acta Obstetricia et Gynecologica Scandinavica. 85(9): 1099—1103. http://dx.doi.org/10.1080/00016340600756896; PMid:16929415

6. Dickinson H, Bain E, Wilkinson D et al. 2014. Creatine for women in pregnancy for neuroprotection of the fetus. Cochrane Database of Systematic Reviews. Issue 12; Art. No. CD010846. DOI 10.1002/ 14651858. CD010846. pub2.

7. Crower C, Hiller J, Doyle L. 2002. Magnesium sulphate for preventing preterm birth in threatened preterm labour. The Cochrane Database of Systematic Reviews. Issue 4. Art. No.:CD001060. DOI 10.1002/14651858.CD001060.

8. Doyle L, Crowther C, Middleton P et al. 2009. Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database of Systematic Reviews. Issue 1. http://dx.doi.org/10.1002/14651858.CD004661.pub3

9. Welin A, Svedin P, Lapatto R et al. 2007. Melatonin reduces inflammation and cell death in white matter in the mid-gestation fetal sheep following umbilical cord occlusion. Pediatric Research. 61;2: 153—158. http://dx.doi.org/10.1203/01.pdr.0000252546.20451.1a; PMid:17237714

10. Lekic T, Manaenko A, Rolland W et.al. 2011. Neuroprotection by melatonin after germinal matrix hemorrhage in neonatal rats. Acta Neurochirurgica. 111: 201—206. http://dx.doi.org/10.1007/978-3-7091-0693-8_34

11. Bax M, Goldstein M, Rosenbaum P et al. 2005. Proposed definition and classification of cerebral palsy. Developmental Medicine and Child Neurology. 47: 571—576. http://dx.doi.org/10.1017/S001216220500112X; PMid:16108461

12. Rouse D, Hirtz D, Thom E. 2008. A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy. N Engl J Med. 28;359(9): 895—905.

13. Catlin E, Carpenter M, Brann B et al. 1986. The Apgar score revisited: influence of gestational age. J Pediatr. 109: 865—868. http://dx.doi.org/10.1016/S0022-3476(86)80715-6

14. Wilkinson D, Brain E, Wallace E. 2013. Melatonin for women in pregnancy for neuroprotection of the fetus (Protocol). Cochrane Database of Systematic Reviews. Issue 5. Art. No.: CD010527. http://dx.doi.org/10.1002/14651858.CD010527