THE EFFICACY AND SAFETY OF MAGNESIUM SULPHATE FOR NEONATAL NEUROPROTECTION IN PATIENTS WITH IMMINENT PRETERM DELIVERIES: EXPERIENCE AT A TERTIARY CARE HOSPITAL

Abstract

Objective The study aimed to find the effect of 4 grams of intravenous bolus antenatal dose of magnesium Sulphate on maternal and neonatal outcomes in preterm births. Material and Methods In a one-year cross-sectional descriptive study,  patients with active preterm labor or those with planned preterm birth at 28-34 weeks of gestation were included. Antenatal magnesium Sulphate was administered as a 4gm IV loading dose over 30 minutes. The data was analyzed with SPSS (version 20), where mean ± standard deviation was used for numerical variables and frequency and percentages for categorical variables. The sample size was 88.  A P value <_0.05 is used as a threshold for statistical significance. Results The mean age of patients was 28.78 (± SD of 6.038) and the mean period of gestation remained 32.04 (±1.868). Similarly, the mean cervical dilatation at which magnesium Sulphate was given was 6.591 (±1.358), the mean baby’s weight was 1.655 (±0.508) kg, and the mean Apgar score at 5 minutes was recorded as 7.11 (±1.208). Regarding the period of gestation of the patients, 15 (17.04%) were at 28-30 weeks, 26 (29.54%) were at 30– 32 weeks and 47 (53.4%) were at 32– 34 weeks. Out of 88 patients, normal vaginal deliveries were conducted in 61 (69.38%) whereas, 27 (30.68%) patients had cesarean sections. Neonatal seizures were observed in 3 (2.6%), intraventricular hemorrhage in 2 (1.754%), Periventricular leukomalacia (PVL) 1(0.877%), and neonatal mortality in 5 (4.38%). Conclusion Magnesium Sulphate is a safe drug that plays an important role in protecting immature brains. Four-gram bolus is a sufficient dose as compared with infusion, which requires additional human resources and risks attached to prolonged infusions. Key Words: Magnesium Sulphate, Preterm Deliveries, Neonatal Neuroprotection, Intraventricular Hemorrhage