Study of the Role of Magnesium Sulphate in Anticipated Preterm Deliveries

The aim of study is to demonstrate the clinical profile of patients requiring MgSO4 for neuroprotection. And to understand the role of MgSO4 for neuroprotection to understand the feasibility of application of the protocol in preterm deliveries of 28 to 34 weeks gestational age and in understanding its importance in preventing neurological impairment. This study was done over a period 1 year where hundred patients who fulfill the inclusion criteria and 100 patients with active labour were recruited for the study. Patients with anticipated preterm delivery were given magnesium sulphate loading dose and maintenance. Functional outcome analysis was done on the basis of neonatal death in immediate postpartum period, Apgar scores and neurological outcome at 2, 4 and 6 months. There is no significant difference in age distribution of mothers who completed magnesium sulphate and who did not complete it. ❖ Majority of them in both groups were in 20 to 25 years age group. There is no significant difference in parity distribution among study and control group. Majority of them were primi gravida, 59% in study group and 54% in control group. There is no significant difference in distribution of gestational age among study and control group. There is no significant difference in lie of babies among study and control group. Majority of them were in cephalic presentation followed by breech and transverse lie. Majority of them had a gestational age of 33-34 weeks. There is no significant past obstetric history among patients. Most of the patients experienced preterm pain for the first time. There is no significant difference in birth weight distribution of babies among study and control group. ❖ Majority of them had a birth weight of 1.5 to 2 kg and 42% had a birth weight of less than 1.5kg. There is an increase in the prevalence of postpartum haemorrhage among study. This may be attributed to the tocolytic effect of magnesium sulphate. There is a significant decrease in the neonatal mortality among magnesium sulphate group. It is 10 % in the study group and 20 % in the control group. There is a significant improvement in APGAR Scores at 1 minute and at 5 minute in babies given magnesium sulphate. The babies with apgar score less than 5 was 8% in study group and 17% in control group. The motor milestones at 2, 4, 6 months are delayed in hypoxic injury to the brain. Only 15% of patients who were given magnesium sulphate had neurological abnormality at the end of 2 months and 4 months as compared to 25% in control group. At the end of 6 months, 10% of the babies who received magnesium sulphate neuroprotection had cerebral palsy as compared to 18% in babies who did not receive magnesium sulphate. CONCLUSION: Antenatal magnesium sulphate neuroprotection, given by zuspan regimen to preterm infants significantly decreases the risk of neurological abnormality and the risk of cerebral palsy. Hence, it is important to implement this protocol worldwide, as it is affordable and easy to administer. It provides for significant reduction in the global health burden