120 Are we using magnesium sulphate too much?: Magnesium sulphate

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• 作者：Thaí ; s Farias Portugal ; Henri Augusto Korkes ; Keliany Carla Duarte de Araú ; jo ; Thaí ; s Travassos da Silva ; Nayanne Silva da Fonseca ; Elisa Chalem ; Nelson Sass
• 刊名：Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：6
• 期：3
• 页码：237-238
• 全文大小：90 K

文摘

Since the publication of the MAGPIE study, the use of magnesium sulphate (MgSO₄) was widespread throughout the world for patients with pre-eclampsia (PE). Except for imminent eclampsia or eclampsia itself, the decision to use is based on subjective clinical aspects. To reduce this pattern of care, the adoption of PIERS as a predictive model has been recommended as a tool which allows evaluating objectively the risk of maternal and/or adverse perinatal outcomes. We found that, in recent years, in our clinical practice the use of MgSO₄ is based on from subjective judgment. The introduction of PIERS tool at our current care routine could support decisions more objectively and reduce patient exposure to a drug that can have side effects?

Objective

To evaluate from PIERS the relative risks of adverse events within 48 hours in patients with PE who used the MgSO₄ based on subjective clinical decision.

Methodology

This study is a retrospective cohort study whose data were obtained through chart analysis and calculation of PIERS from patients diagnosed with PE and had received MgSO₄ between January and May 2016. Patients with outcome already installed, as eclampsia, were excluded. PIERS calculator was accessed on the website: https://pre-empt.cfri.ca/monitoring/fullpiers.

Results

From 50 patients with PE in the period, 21 used the MgSO₄ by severe PE. Table 1 shows frequencies of relative risk calculated. Among the total of 21 patients, 33.3% had risk less than 1.0% and 47.6% less than 47.6%. Just in two patients PIERS was above 10.0%. No patient had side effects related to the use of MgSO4 or adverse outcome installed within 48 h after delivery.

Discussion

We found that a high percentage of patients with low risk estimated by PIERS were submitted to MgSO4. Probably the incorporation of PIERS calculator in decisions in patients with PE could reduce uncertainties and improve the standard of care. Despite the small number of patients included, apparently we are using magnesium sulfate too much. Thanks to FAPESP. Processo n^o 2014-00213/7.