Maternal and Child Science | How much do you know about the special application of magnesium sulfate in obstetrics?

For pregnant women with gestational hypertension, magnesium sulfate is particularly important. As an antispasmodic drug, it is used in patients with gestational hypertension, preeclampsia, and eclampsia to prevent and control convulsions. Its main role The mechanism is to stimulate the synthesis of prostaglandins in the body and inhibit the response to angiotensin II, thereby relieving vascular spasm. Magnesium sulfate can be administered intramuscularly or intravenously. Intramuscular injection usually reaches the peak concentration 2 hours after administration, and the action time in the body is long, but the local irritation is strong. Attention should be paid to deep intramuscular injection with a long needle during injection. After intravenous administration, the effective level can be reached quickly, and the blood drug concentration decreases rapidly after drug withdrawal. In clinical practice, two methods are often used to complement each other.

A common sequelae of premature infants is cerebral palsy. For pregnant women with threatened preterm labor whose gestational age is less than or equal to 32 weeks, the routine application of magnesium sulfate can reduce the incidence of cerebral palsy, because another effect of magnesium sulfate is to protect the fetal cranial nerves.

In addition to the above-mentioned effects, magnesium sulfate also has the effect of reducing swelling, especially for patients with postpartum perineal edema and postpartum mastitis, magnesium sulfate wet compress can play a good role.

So what are the precautions for the application of magnesium sulfate? Since the therapeutic concentration of magnesium sulfate is similar to the toxic concentration, the toxic effects of magnesium sulfate should be closely observed and the intake of magnesium sulfate should be carefully controlled. During the medication, the blood pressure of pregnant women should be monitored, and the presence of knee tendon reflex should also be monitored; breathing should not be less than 16 times; urine output should not be less than 600ml every 24 hours, or not less than 25ml per hour. Always have 10% calcium gluconate injection ready for detoxification in case of toxic effects. The intravenous injection of 10% calcium gluconate 10ml should be completed within 3 minutes, and if necessary, it can be repeated every hour until breathing, urination and nerve depression return to normal, but not more than 8 times within 24 hours.