Use of Magnesium Sulphate before 32 weeks of gestation: a European population-based cohort study
Wolf HT, Huusom L, Weber T, Piedvache A, Schmidt S, Norman M, Zeitlin J and the EPICE Research Group
BMJ Open (2017)
Magnesium sulphate has long been used in obstetric practice, but its current use is unknown. We aimed to explore reported policies of use of magnesium sulphate and the actual use in European obstetrical units by indication (eclampsia prophylaxis, fetal neuroprotection and tocolysis) in women giving birth before 32 weeks of gestation. We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort which is a large population-based multinational cohort.
We found that evidence-based use of magnesium sulphate was applied much less than expected in European obstetric units. Only 35% of women diagnosed with severe preeclampsia, eclampsia or HELLP were treated with magnesium sulphate. Among women without preeclampsia, only 2.6% were treated. Our results therefore suggest that European obstetricians are not convinced by available evidence on magnesium sulphate’s neuroprotective effect. Only one unit stated using magnesium sulphate as a first-line tocolytic.
Our results provide a useful baseline for evaluating practice changes as more evidence becomes available and more national societies develop guidelines for use of magnesium sulphate for neuroprotection.
See article here: http://bmjopen.bmj.com/content/7/1/e013952