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Re: Mg for ALL preeclampsia and PIH ???????? From: ainsron (ainsron@sbcglobal.net) Fri May 18 13:12:21 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Mg for ALL preeclampsia and PIH ????????" Previous message: Joanne Bulley, MD: "Re: Mg for ALL preeclampsia and PIH ????????" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Mg for ALL preeclampsia and PIH ????????" Next in thread: Garry E. Siegel, M.D.: "Re: Interesting pregnancy case =?iso-8859-1?b?lg==?= suggestions?" I would have to disagree with you. I've always worked in hospitals with 50-60 deliveries per month, since residency. Our nursing staff and pharmacy have been very meticulous about their preparation of medications. It is an issue watched closely by JCAHO. In fact, very few admixtures are made in OB anymore, they are premixed and come directly from the pharmacy who watch them like a hawk. I would be more concerned about this issue in large hospitals with high turnover in nursing and pharmacy staff. In small hospitals, staff tend to watch each other's backs and take a personal interest in their patients. It isn't a delivery mill. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. Sent: Friday, May 18, 2007 7:01 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Mg for ALL preeclampsia and PIH ???????? At Fri, 18 May 2007, Andrew Folley wrote: > ?????????????? > >Take-Home Pearl: Since eclampsia is also associated with an increased risk >of maternal morbidity and neonatal morbidity, one should be cautious about >the selective use of magnesium sulfate prophylaxis. > The problem with the use of Mg S04 for mild preeclampsia is that when you get to centers with low birth rates ie less than 1500 you are likely to order it and have it mixed by a pharmacy or nurse that has never done it before, its not unusal for a 4 gram bolus to become a 40 gram bolus. There is actually a trial being started comparing labetolol Vs. MgSo4 for eclampsia prevention; if labetolol was almost as good as MgSo4 it would be the right choice for small volume centers and devolping world centers, precautions for oral or I.V. labetolol are a walk in the park compared to MgSo4. -- Take care, John Next message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Mg for ALL preeclampsia and PIH ????????" Previous message: Joanne Bulley, MD: "Re: Mg for ALL preeclampsia and PIH ????????" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Mg for ALL preeclampsia and PIH ????????" Next in thread: Garry E. Siegel, M.D.: "Re: Interesting pregnancy case =?iso-8859-1?b?lg==?= suggestions?"

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