Author/Editor		Franić, D; Novak-Antolič, Ž; Jurjec, D; Zore, A
Title		Magnesium sulfate as tocolytic agent
Translated title		Magnezijev sulfat kot tokolitik
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 64, št. 1
Publication year		1995
Volume		str. 3-7
Language		eng
Abstract		Background. The aim of this prospective study was to investigate the properties of magnesium sulfate in pharmacologic inhibition of premature labor (PL). Methods. One part of the study included fifteen patients with the diagnosis of PL (Protocol "M"), who were treated with MgSO4 (1.6 gr/h during 72 h). The other part of the study included ten patients, who were treated with ritodrine (150 mg/500 mg of 5 percent glucose infusion at a rate of 0.1 mg/ml = 20 drops/min during 72 h) (Protocol "R"). All patients had singleton pregnancies, intact membranes, gestational age 30-36 weeks, cervical changes with Bishop index 4, and/or cervical dilatation 4 cm. There were no maternal or fetal contraindication for tocolytic therapy. Results. The mean magnesium levels before starting tocolytic therapy was 0.57 mmol/l, which supports the hypothesis, that hypomagnesemia under 0,60 mmol/l might be a predicator for PL. The mean magnesium level to achieve tocolysis was 1.28 mmol/l. In criterium for successfull tocolysis was the prolongation of pregnancy for more than 72 h. The time needed to achieve tocolytic effect was 18.3 h for MgSO4 and 11.8 h for ritodrine. There were two cases of failure on both groups. Side effects were much more alarming in the ritodrine group than in the MgSO4 group, but it was not necessary to stop the tocolysis. Conclusions. MgSO4 was found to be a successful, inexpensive and probably nontoxic tocolytic agent, as effective as ritodrine. The dose used in our study was low, but still effective enough to achieve the tocolysis.
Summary		Izhodišča. Namen naše prospektivne raziskave je bil ugotoviti, prvič v Sloveniji, učinkovitost MgSO4 za preprečevanje grozečega prezgodnjega poroda. Metode. V en del raziskave smo v skupino "M" vključili 15 nosečnic z diagnozo prezgodnjega poroda, ki so bile zdravljene z MgSO4 in sicer 1,6 g/h v infuziji 72 ur. V drugi del raziskave, v skupino "R" smo vključili 10 nosečnic, ki so bile zdravljene z ritodrinom in sicer s 150 mg/500 ml infuzije s hitrostjo 0,1 mg/ml = 20 gtt/min tudi 72 ur. Pri vseh nosečnicah je šlo za enoplodno nosečnost, ohranjene plodove ovoje, gestacijsko starost 30-36 tednov, spremembe na materničnem vratu, z oceno po Bishopu 4, in/ali odprtim materničnim ustjem 4 cm. Ni bilo nobenih maternalnih ali fetalnih kontraindikacij za tokolizo. Rezultati. Srednja koncentracija Mg v plazmi pred začetkom tokolize je bila 0,57 mmol/l, kar je v prid hipotezi, da je hipomagnezija 0,60 mmol/l lahko znak grozečega prezgodnjega poroda. Srednja koncentracija Mg v plazmi, s katero smo dosegli tokolitični učinek je bila 1,28 mmol/l. čas v katerem smo dosegli tokolitični učinek je bil za MgSO4 18,3 h in 11,8 h za ritodrin. Kriterij za uspešnost tokolize je bilo podaljšanje nosečnosti za 72 ur in več. Pri dveh nosečnicah v vsaki skupini tokoliza ni uspela. Stranski učinki so bili pri nosečnicah, ki so dobivale ritodrin, mnogo bolj izraženi, kot pri nosečnicah, ki so dobivale MgSO4. Zaradi stranskih učinkov ni bilo treba prekiniti zdravljenja. Zaključki. Ugotovili smo, da je MgSO4 tokolitik, ki po učinkovitosti ne zaostaja za ritodrinom, različen je samo čas, ki je potreben z a tokolitični učinek. Odmerki ki smo jih uporabljali v naši študiji, so majhni, vendar zadostni za uspeh tokolitičnega zdravljenja. Za natančnejšo analizo učinkovitosti MgSO4 bi bilo treba narediti randomizirano, s placebom kontrolirano raziskavo.
Descriptors		LABOR, PREMATURE TOCOLYSIS MAGNESIUM SULFATE RITODRINE