MGSO4

Question 1

Which is false?

a) MgSO4 is indicated for fetal neuroprotection from viability to 31+6
b) If MgS04 has been started for fetal neuroprotection, tocolysis should be discontinued.
c) If a patient has already received a dose of MgSO4 then stops labouring, she should receive a second course if delivery is imminent before 32 weeks
d) The use of MgSO4 is associated with neonatal hypotonia and apnea

Answer 1

c

Question 2

Which is false?

a) CNS complications in the preterm infant are associated with intraventricular hemorrhage and/or white matter changes
b) The risk of cerebral palsy is inversely related to gestational age at birth
c) “Imminent birth” is defined as active labour with 4 or more cm cervical dilatation
d) NNT to prevent one case of CP is 8

Answer 2

d)
NNT to prevent case of death/CP = 43
NNT to prevent case of CP = 62
NNT to prevent eclampsia amongst women with severe eclampsia = 50

Question 3

Name 3 contraindications to MgSO4 use:

Answer 3

1) hypersensitivity to the drug
2) myasthenia gravis
3) hepatic coma
4) caution in renal impairment

Question 4

What are the maternal side effects of MgSO4?

Answer 4

1) apnea
2) weakness
3) flushing/sweating
4) nausea/vomiting
5) hypotension/tachycardia (rare but serious)

Question 5

What are the neonatal symptoms of hyper-magnesemia?

Answer 5

1) apnea
2) hypoventilation
3) weakness
4) hypotonia
5) absent reduced reflexes
6) stupor/coma

Question 6

Can you use MgSO4 while also using nifedipine?

Answer 6

You can. Theoretical risk of neuromuscular blockade with CCB (old books said contraindicated) has not panned out. Should not use tocolytic at same time as MgS04 in general.