title: Implementation of an antenatal magnesium sulfate protocol for fetal neuroprotection in preterm infants.
abstract: The aim of our study was to assess the feasibility of implementing a protocol for the use of magnesium sulfate to prevent cerebral palsy. This retrospective single-center study included all women with fetuses of gestational age <33 weeks of gestation whose birth was planned or expected within 24 hours from September 2011 to December 2012. They were to receive magnesium sulfate, administered intravenously as a 4-g bolus followed by a constant infusion of 1 g per hour. If delivery had not occurred after 12 hours and was no longer considered imminent, the infusion was to be discontinued. The study included 119 women, 81 (68.1%) of whom received magnesium sulfate. Among the latter, 71 (87.5%) gave birth within 24 hours. The reasons treatment was not given were: omission by medical team (19/38, 50%), urgent delivery (18/38, 47.4%), and contraindication to treatment (1/38, 2.6%). The mean gestational age at protocol implementation was 29.6 +/- 2.1 weeks. Maternal monitoring, especially at the onset of infusion, appeared suboptimal. No major maternal side effects were observed. Our study shows that implementing a protocol for prevention of cerebral palsy by magnesium sulfate is feasible in a tertiary obstetric center.
authors.affiliation: Department of Obstetrics and Gynecology, Montreal University Hospital-Montreal-Canada.
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Bouet
authors.affiliation: Department of Obstetrics and Gynecology, Bordeaux University Hospital-Bordeaux-France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Brun
authors.affiliation: Department of Obstetrics and Gynecology, Bordeaux University Hospital-Bordeaux-France.
authors.forename: Hugo
authors.initials: H
authors.lastname: Madar
authors.affiliation: Department of Obstetrics and Gynecology, Angers University Hospital-Angers-France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Baisson
authors.affiliation: Department of Obstetrics and Gynecology, Angers University Hospital-Angers-France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Courtay
authors.affiliation: Department of Neonatal Medicine, Angers University Hospital-Angers-France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Gascoin-Lachambre
authors.affiliation: Department of Anesthesiology, Angers University Hospital-Angers-France.
authors.forename: Sigismond
authors.initials: S
authors.lastname: Lasocki
authors.affiliation: Department of Obstetrics and Gynecology, Bordeaux University Hospital-Bordeaux-France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Sentilhes
mesh_terms: D000328:Adult; D002547:Cerebral Palsy / Q000503:physiopathology / Q000517:prevention & control*; D004334:Drug Administration Schedule; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008991:Monitoring, Physiologic; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature / Q000503:physiopathology*; D011247:Pregnancy; D012189:Retrospective Studies; D062606:Tertiary Care Centers
chemical_list: D018696:Neuroprotective Agents; D008278:Magnesium Sulfate