What is the role of prophylactic magnesium sulfate in the treatment of preeclampsia?

Updated: Nov 29, 2018
  • Author: Kee-Hak Lim, MD; Chief Editor: Ronald M Ramus, MD  more...
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Prophylactic treatment with magnesium sulfate is indicated for all patients with severe preeclampsia. However, no consensus exists as to whether patients with mild preeclampsia need magnesium seizure prophylaxis. Although ACOG recommends magnesium sulfate in severe preeclampsia, it has not recommended this therapy in all cases of mild preeclampsia.

Some practitioners withhold magnesium sulfate if BP is stable and/or mildly elevated and if the laboratory values for LFTs and platelets are mildly abnormal and/or stable. Other physicians feel that even patients with gestational hypertension should receive magnesium, as a small percentage of these patients may either have preeclampsia or may develop it. The ultimate decision should depend on the comfort level of the labor and delivery staff in administering intravenous (IV) magnesium sulfate. An estimated 100 patients need to be treated with magnesium sulfate therapy to prevent 1 case of eclampsia. [5, 67, 68]

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