Use of magnesium sulfate in preterm deliveries for neuroprotection of the neonate TOG 2017

Question 1

What is the incidence of cerebral palsy
22-27 weeks
28-31 weeks
32-36 weeks
term

Answer 1

22-27 weeks 15%
28-31 weeks 6%
32-36 weeks 0.7%
term 0.1%

Question 2

Preterm delivery is the cause of what % of cerebral palsy?

Answer 2

35%

Question 3

What 2 patterns of injury to the central nervous system underlie the development of CP?

Answer 3

Intraventricular haemorrhage
Periventricular leucomalacia (PVL)

Question 4

How common iv PVL for infants <1500g

Answer 4

2-3%
Develop lesions in what mater as well as cerebral necrosis

Question 5

How common is impairment in fine motor skills for babies born <32 weeks?

Answer 5

40-60%

Question 6

Relationship of sensorinearal impairment and preterm delivery?

Answer 6

< 32 weeks: 2% 3 visual impairment
PVL: 52% visual impairment
<28 weeks: 2% BL hearing loss

Question 7

How common is delayed developmental outcome for babies born 23-26 weeks?

Answer 7

60%
20% severe delay

Question 8

RCOG recommended MgSU for what gestation & what dose?

Answer 8

Women between 24+0 and 29+6 weeks of pregnancy who are in established preterm labour or having a planned preterm birth within 24 hours

4g IV bolus over 15 minutes
Followed by IV infusion of 1 g per hour until birth or for 24 hours (whichever is sooner)

Question 9

Monitoring requirements whilst on MgSu?

Answer 9

4 hourly pulse rate, resp rate, BP and deep tendon reflexes.
Monitor urine output

Question 10

What is given in MgSu toxicity?

Answer 10

Calcium gluconate