Samol John M, Lambers Donna S
Department of Obstetrics and Gynecology, Good Samaritan Hospital, Cincinnati, Ohio, USA.
Am J Obstet Gynecol. 2005 May;192(5):1430-2. doi: 10.1016/j.ajog.2005.02.093.
This study was undertaken to determine the: (1) risk factors for developing pulmonary edema associated with magnesium sulfate (MgSO4) tocolysis; (2) mean latency period to diagnosis; (3) role of maternal transport; and (4) safety of continued therapy.
A total of 150 antenatal patients treated for preterm labor with MgSO4 were identified for this retrospective, case-control study. Cases were compared 1:2 with controls in regard to maternal demographics, MgSO4 concentration and infusion rates, maternal transport status, and maternal net fluid balance.
Risk factors for developing pulmonary edema include: greater MgSO4 and intravenous fluid infusion rates, less concentrated MgSO4, infection, multiple gestations, concomitant tocolytics, large positive net fluid balances, and maternal transport. The mean latency period to diagnosis was 1.96 days. Six percent of patients had recurrence if MgSO4 tocolysis was continued.
MgSO4 and intravenous fluid rates are both associated with the development of pulmonary edema. Once appropriately treated, MgSO4 tocolysis can be continued with little risk of recurrence.
本研究旨在确定：（1）与硫酸镁（MgSO4）抑制宫缩相关的肺水肿发生的危险因素；（2）诊断的平均潜伏期；（3）孕产妇转运的作用；（4）继续治疗的安全性。
本回顾性病例对照研究共纳入150例接受MgSO4治疗早产的产前患者。病例与对照在孕产妇人口统计学、MgSO4浓度和输注速率、孕产妇转运状态以及孕产妇净液体平衡方面按1:2进行比较。
发生肺水肿的危险因素包括：较高的MgSO4和静脉输液输注速率、浓度较低的MgSO4、感染、多胎妊娠、同时使用抑制宫缩药物、大量正性净液体平衡以及孕产妇转运。诊断的平均潜伏期为1.96天。如果继续进行MgSO4抑制宫缩治疗，6%的患者会复发。
MgSO4和静脉输液速率均与肺水肿的发生有关。一旦得到适当治疗，继续进行MgSO4抑制宫缩治疗复发风险很小。
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