TITLE:
Strategies to prevent preterm birth and cerebral palsy: Compliance with current recommendations
AUTHORS:
Amanda Meyer, Nancy Cipparrone, Andrea Buras, Barbara V. Parilla
KEYWORDS:
Magnesium Sulfate; Neuroprotection; Preterm Delivery
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.2,
February
11,
2014
ABSTRACT: Objective: Magnesium sulfate (MgSO4)
administration to patients with preterm delivery has been associated with a
decrease in cerebral palsy. At our institution, a protocol was established
regarding the administration of magnesium sulfate for patients in preterm labor
at less than 32 weeks of gestation. Despite this protocol, not all eligible
patients received this therapy. The purpose of this study was to investigate
potential barriers to MgSO4 administration. Methods: A retrospective
chart review was performed of those patients who received the diagnosis of “Early
Onset Delivery” or “preterm labor” from January through December of 2010, to
see what therapies were offered and received. Results: 119 patients met initial
criteria. Of those, 68 patients had preterm labor less than 32 weeks. 15 of the
68 patients (22%) received MgSO4. Of those patients that did not
receive MgSO4, only 6 delivered 4,
and those that were eligible and did not. Potential barriers included short
time frame from presentation to delivery, treatment not considered by
healthcare provider, and unanticipated delivery. No patient declined therapy. Conclusions:
At our institution, the rate of MgSO4 administration for
neuroprotection to eligible candidates was 75%. The subgroup of patients where
MgSO4 was not administered in eligible candidates was unanticipated
delivery (4), and premature rupture of membranes (1). A 4 gram load of MgSO4 should be attempted prior to delivery of eligible patients, as this strategy
has also been shown to be of benefit.