Prior to the 1980s magnesium sulphate was widely used in the United States in the intrapartum management of pre-eclampsia and eclampsia and the clinical impression that magnesium sulphate made induction of labour more difficult led to its evaluation as a tocolytic agent. With the withdrawal of sympathomimetic drugs from the
American market and the failure of atosiban, an oxytocin antagonist, to obtain FDA approval, there are no licensed tocolytic drugs available for the American obstetrician to use and magnesium sulphate is therefore in common use (Fig. 21.6). However, randomized placebo-controlled trials of magnesium sulphate show no significant short-term delay of delivery, increase in birthweight or difference in perinatal mortality when compared to placebo. Studies where magnesium has been compared to sympathomimetics have suggested equal efficacy. These two apparently contradictory findings can probably be explained by the lack of power of the studies to detect a significance difference between drugs with little or no efficacy but a high placebo response rate.
Was this article helpful?
Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.