MgSO4 is contraindicated in eclampsia if following occurs during treatment EXCEPT -
(Respiratory rate < 16) (234-35 Dutta 7th; Internet)Magnesium sulphate is a smooth muscle relaxant. Reduction or loss of tendon reflexes precedes respiratory depression, and should be immediately noted.Deep Tendon Reflexes Elicit, grade, and record: 15 minutes during the first 2 hours of therapy, then hourly thereafterContraindications to Magnesium Sulfate Usea. Myasthenia gravisb. Heart block/recent myocardial infarctionc. Severe renal diseased. Signs of magnesium toxicityThe consultant should be alert if the woman experiences any of the following signs/svmptoms:* Significant changes in BP from baseline values* Tachycardia or bradycardia* Respiratory rate < 14 or >24* Oxygen saturation <95%* Changes in breath sounds suggestive of pulmonary edema* Changes in level of consciousness or neurologic status* Absent DTRs* Urinary output <30 mL/hr* Any concerns about the fetal heart rate pattern (Classes II and III tracings)Magnesium Sulfate can cause fetal abnormalities when administered beyond 5 to 7 days to pregnant women.There are retrospective epidemiological studies and case reports documenting fetal abnormalities such as hypocalcemia, skeletal demineralization, osteopenia and other skeletal abnormalities with continuous maternal administration of Magnesium sulfate for more than 5 to 7 days.* Magnesium sulphate is the drug of choice in Eclampsia also used in Torsades de points.* The therapeutic level of serum magnesium is 4 - 7 mEq/L* Benefits:(i) It controls fits effectively without any depression effect to the mother or the infant.(ii) Reduced risk of recurrent convulsions.(iii) Significantly reduced maternal death rate (3%).(iv) Reduced perinatel mortality.* Repeat injections are given only(i) Knee Jerks are present.(ii) Urine output exceeds 30 ml/hour(iii) Respiration rate is more than 12 per minute.* Magnesium sulfate is useful as an additional bronchodilator in patients with acute severe asthma (1045 - Good man and Gillman 12th)* Contraindication of magnesium sulfate in a pregnancy with late onset diabetes mellitus and sensory deafness due to mitrochondrial myopathy.Adverse effect of magnesium sulfate.* Diaphoresis* Depressed reflexes* Facial flushing* Reduced heart rate* Hypotension* Circulatory collapse * Respiratory depression
Urine output is <30 ml/hr
Respiratory rate < 16
Diastolic BP <90
Knee jerk absent
Miscellaneous (Gynae)