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KMID : 0377619840470060319
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Korean Jungang Medical Journal
1984 Volume.47 No. 6 p.319 ~ p.326
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The Use of Magnesium Sulfate for the Inhibition of Preterm Labor
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Abstract
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Management of preterm labor remains one of the major problems of modern obst-etrics. Once preterm labor occurs, aggressive tocolytic management will afford the :maximum chance for good perinatal outcome. Various drugs have been used to inhibit preterm labor. But magnesium sulfate is highly acceptable as the primary tocolytic agent because it offers comparable success with minimal maternal and fetal physiol-ogic changes compared to other agents.
In order to report our experience with magnesium sulfate as a tocolytic agent, a- comparative clinical study were done. Forty patients who were treated with magnesium sulfate and forty two treated with bed rest and dextrose in water as a control group was carried out. All eighty two patients were admitted and treated at the department of obstetrics and gynecology of Yonsei Medical Center from January 1981 to June 1984.
Success of tocolysis was defined as the postponement of delivery for more than -three days.
The results were as follows:
1. Delivery was postponed for more than 3 days in 27 of 40 patients (68%) with the magnesium sulfate treated group and in 14 of 42 patients (33%) with the control group. The difference was significant (p<0.01).
2. The mean time gained from the initiation of tocolytic therapy to delivery in all magnesium sulfate treated group was 32.3 days different from that of 9.4 days gained in the control group.
3. The magnesium sulfate was significantly effective than the control group in inhibition of preterm labor in multigravid patients (p<0.05). But there was no significant difference of success rate in primigravid patients (p> 0. 1).
4. In patients with intact fetal membrane status the success rate in the magnesium sulfate treated group was significantly higher than the control group (p <0.01), whereas those with ruptured membrane success rate was not different significantly (p> 0. 1).
5. The success rate between the magnesium group and the control group was not different significantly in pelvic score 1?4 and 9?12 (p>0.1). But it was very high with the magnesium treated group than the control group in pelvic score 5?8(p<0. 03).
6. The duration of gestation did not appear to play an important role. There was no significant difference of success rate between the magnesium sulfate treated group and the control group in 21?28 weeks (p> 0.1), 29?32 weeks (p> 0. 1), and 33?36 weeks (p>0.05) respectively.
7. Five complaints of unwanted effects were noted in 3 magnesium sulfate treated patients.
8. Fifteen infants (37/) in the magnesium sulfate treated group and five infants (13%) in the control group had births weights in excess of 2500 gms. This difference was significant (p<0.05). Six babies with the magnesium sulfate treated group and four with the control group died from respiratory distress syndrome.
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