Respiratory compromise after MgSO4 therapy for preterm labor in a woman with myotonic dystrophy: a case report.
BACKGROUND
MgSO4 is widely used for tocolysis. Serious complications are rare as long as dosing is carefully monitored. Adverse effects in muotonic dustrophy have not been previously described.


METHODS
A 35-year-old woman, gravida 1, para 0, was hospitalized with suspected mild myotonic dystrophy, polyhydramnios and preterm labor at 33 weeks. MgSO4 infusion rapidly resulted in respiratory compromise. Muscular strength returned to baseline after the infusion was stopped. Mother and infant proved to have myotonic dystrophy.


CONCLUSIONS
The choice of tocolytic medication in maternal myotonic dystrophy is problematic. Beta-2 sympathomimetics have been reported to precipitate myotonia. This case illustrates the potential for MgSO4 to cause respiratory embarrassment. Indomethacin may be the tocolytic of choice in myotonic dystrophy.
Catanzarite
Val
V
Department of Maternal Fetal Medicine, Sharp Mary Birch Hospital for Women and San Diego Perinatal Center, 92123, USA. vcatanza@aol.com
Gambling
David
D
Bird
Lynne M
LM
Honold
Jose
J
Perkins
Erik
E
D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008278:Magnesium Sulfate / Q000009:adverse effects*; D009222:Myotonia / Q000139:chemically induced*; D009223:Myotonic Dystrophy / Q000188:drug therapy* / Q000235:genetics; D007752:Obstetric Labor, Premature / Q000188:drug therapy / Q000517:prevention & control*; D011247:Pregnancy; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D015145:Tocolysis; D015149:Tocolytic Agents / Q000009:adverse effects*
D015149:Tocolytic Agents; D008278:Magnesium Sulfate