الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Placenta praevia is a lower-uterine placenta. This incorrect position causes abnormal haemorrhage and premature labour. Tocolytics may slow uterine contractions and extend pregnancy in women with placenta praevia. Aim: To compare the relative efficacy of two magnesium sulphate regimens in the treatment of women with symptomatic placenta previa in preterm labour . Methods: A RCT study randomly assigned 130 patients to two groups. All patients received a 4g intravenous magnesium sulphate loading dose on 150 ml saline over 20 minutes. After random assignment, patients received magnesium sulphate maintenance therapy at 1g/h (low dosage group) or 2g/h (high dose group). For further investigation, patients were classified into subgroups (non-obese and obese). Results: Clinical and pregnancy prolongation data showed no significant difference between the two therapy regimens. The high-dose group had a considerably longer cervical length (cm) at 48 hours (p<0.001).The low-dose group had a lower 4-hour magnesium level (3.98±0.60 vs 4.80±0.91;p<0.001). Furthermore, when comparing subgroups based on obesity, our analysis revealed a significant increase in non-obese women delivering after 48 hours in high and low groups. Cervical length after 48 hours (cm) was also increased in the non-obese high dose group (p<0.030). Non-obese pregnancies treated with high-maintenance tocolysis achieve a therapeutic level of magnesium than obese pregnancies treated with high intravenous magnesium alone (36.1%vs.6.9%, p=0.007). Conclusions: This investigation demonstrates that a high magnesium sulphate intervention in cases of symptomatic preterm previa in non-obese women may be related with potential clinical prolongation of pregnancy, an increase in cervical length and achieve therapeutic magnesium level. |