Intrapartum fetal distress and magnesium sulfate.
OBJECTIVE
Intrapartum fetal distress is an obstetric emergency traditionally managed by immediate delivery by either the vaginal route or cesarean section. However, there is usually time to attempt intrauterine resuscitation. The purpose of this study was to report the utilization of magnesium sulfate for intrauterine resuscitation.


METHODS
Twenty-one fetuses received magnesium sulfate 4-g intravenous bolus in mothers awaiting cesarean section for fetal distress in the labor room of the Complejo Hospitalario Metropolitano de la Caja de Seguro Social de Panamá, from March through August 1997. Fetal distress in labor was defined as the presence of repetitive late decelerations, persistent loss of baseline variability, severe variable decelerations, or bradycardia.


RESULTS
Twenty-one fetuses received magnesium sulfate 4-g intravenous bolus in mothers awaiting cesarean section for fetal distress. Uterine activity ceased in seven patients, diminished in 13 patients and did not change in one. In all cases, but one, there was recovery of the FHR within 4 min; furthermore there was rose reactive of FHR in nine patients. The 1-min Apgar scores were 7 or above in 18 cases and the 5-min Apgar scores were 7 or above in 20 patients.


CONCLUSIONS
In summary, magnesium sulfate may be useful in the management of acute intrapartum fetal distress when there is evidence of increased uterine activity.
Vigil-De Gracia
P
P
Department of Obstetrics and Gynecology, Complejo Hospitalario Metropolitano de la Caja de Seguro Social, Panama City, Panama.
Simití
E
E
Lora
Y
Y
D000889:Anti-Arrhythmia Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005316:Fetal Distress / Q000188:drug therapy*; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D008278:Magnesium Sulfate / Q000494:pharmacology / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D015149:Tocolytic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D015149:Tocolytic Agents; D008278:Magnesium Sulfate