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Re: Magnesium Sulfate increases perinatal mortality?? From: Robert P. Lorenz, M.D. (rlorenz@beaumont.edu) Tue Dec 30 12:03:37 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Terrence.Jones@ncal.kaiperm.org: "Re: Continue ERT/Recert Exam" Previous message: Malcolm Griffiths: "Re: OB:Prenatal Rituals" In reply to: Richard Lowensohn: "Re: Magnesium Sulfate increases perinatal mortality??" Next in thread: Richard Lowensohn: "Re: Magnesium Sulfate increases perinatal mortality??" At Thu, 25 Dec 1997, Richard Lowensohn wrote: > >Robert - > > As I understand it, the article is short due to the pressure for rapid >publication, since they found an unexpected bad outcome. Mag has also been our >first-line drug. We discussed the article, and agreed that it was worrisome. It >does, so far, seem to stand alone in its findings. We have decided to discuss it >further with our neonatologists, but have been trying out the agressive >nifedipine regimen mentioned in the editorial. So far, I'm not too impressed. > >-- >Richard Lowensohn MD >Oregon Health Sciences University >lowensoh@ohsu.edu > >>>> Robert P. Lorenz, M.D. <rlorenz@beaumont.edu> 12/24/97 07:55am >>> >> >>R. Mittendorf et al. (Lancet 350:1517-1518, Nov 22, 1997) published a >>randomized study of magnesium sulfate as a tocolytic and found increased >>perinatal mortality. This and associated commentary (P. Bennett & D. >>Edwards, Lancet 350:1491, Nov 22, 1997) suggests use of this drug for >>preterm labor should be reevaluated. At our institution, magnesium >>sulfate is the drug of choice for preterm labor. The article is short, >>shorter than most peer review publications, I don't know the review >>process before publication. I would be interested in reactions of >>ob/gyns, maternal fetal medicine specialists, neonatologists. Thanks. >>Robert P. Lorenz, M.D.; Div Maternal Fetal Medicine, William Beaumont >>Hospital, Royal Oak, MI >.. > -- Robert P. Lorenz, M.D. Richard, thanks for your comments. We have used indomethacin occasionally, but have seen adverse neonatal sequelae. The most interesting was a multiple birth with two of the babies developing intestinal perforations, not NEC, which I have been told can happen after neonatal treatment with indomethacin. They had surgery and recovered. But there is no free lunch. Calcium channel agents we tried, but blood pressure problems have occurred. I wouldn't be surprised if all of us are treating premature labor with steroids only in the not too distant future. Next message: Terrence.Jones@ncal.kaiperm.org: "Re: Continue ERT/Recert Exam" Previous message: Malcolm Griffiths: "Re: OB:Prenatal Rituals" In reply to: Richard Lowensohn: "Re: Magnesium Sulfate increases perinatal mortality??" Next in thread: Richard Lowensohn: "Re: Magnesium Sulfate increases perinatal mortality??"

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