The use of magnesium sulfate for tocolysis in preterm labor complicated by twin gestation and betamimetic-induced pulmonary edema.
Maternal cardiorespiratory compromise has been reported to occur during the treatment of preterm labor with tocolytic agents. The risk for these complications is increased by the following factors: multiple gestation, the combination of magnesium sulfate and beta-adrenergic agonist, and the use of adrenocortico-steroids to hasten fetal pulmonary maturity. A case is presented of labor at 28 weeks' gestation complicated by pulmonary edema associated with the three risk factors listed above. The beta-agonist was discontinued with resolution of pulmonary edema. Intravenous magnesium sulfate was continued for 11 days. When uterine contractions finally overcame the tocolysis, delivery occurred. It appeared that uterine quiescence was achieved through the continued use of magnesium sulfate despite pulmonary edema in this case. The risk of continued tocolysis seemed to be counterbalanced by the benefits of prolonged intra-uterine existence for the fetuses.
D000328:Adult; D001623:Betamethasone / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate / Q000009:adverse effects*; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000187:drug effects*; D011654:Pulmonary Edema / Q000139:chemically induced*; D012306:Risk; D012312:Ritodrine / Q000009:adverse effects*
D008278:Magnesium Sulfate; D001623:Betamethasone; D012312:Ritodrine