Antenatal magnesium sulfate (MgSO4) regimens for neuroprotection in preterm neonates

Aim: to assess the comparative effectiveness and adverse effects of different magnesium sulfate (MgSO4) regimens for fetus neuroprotection in women who are considered at risk of preterm birth. Materials and Methods. This randomized controlled clinical single-center study was taken place at the Obstetrics and Gynecology Department of Tanta University Hospital, a tertiary care referral center and neonatology department. The research was carried on pregnant female with gestational age 24–34 weeks with established preterm labor. The patients were sorted into four groups at random. Number of cases in each group was 20 cases, and they were assigned to one of the four groups using a computer-based program. All groups of women had received care in accordance with accepted clinical standards. Throughout the infusion, the protocol required that the mother's heart rate, blood pressure, breathing rate, tendon reflexes, and any negative effects be recorded. Throughout labor, the fetal heart rate had been checked. Mothers and their newborns were monitored until they were released from the hospital. Results. There are different regimens for its use, and there was no difference between all the regimens in its effect for neuroprotection either clinically or radiologically or in its safety, so we recommend the use of the least dose (loading dose 4 g over 30 minutes) to decrease the risk of side effects. Conclusion. It is recommended to use MgSO4 for neuroprotection as it is a safe feasible effective and efficient method as well as it can prevent the trans cranial ultrasound positive findings for encephalopathy. MgSO4 prevents cerebral palsy by age 2, but its effect on cognition and behavior at school age remains uncertain and warrants further study.