Keeley M M, Wade R V, Laurent S L, Hamann V D
Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, North Carolina.
Obstet Gynecol. 1993 Feb;81(2):191-4.
To evaluate the effects of magnesium on fetal hemodynamics in mothers treated with magnesium sulfate for preterm labor.
Twenty women who presented to the Carolinas Medical Center in preterm labor between 24-35 weeks' gestation were enrolled in the study. Pulsed-wave Doppler measurements were made from the fetal middle cerebral artery, the fetal umbilical artery, and the maternal uterine arteries before the initiation of magnesium sulfate tocolysis and during its intravenous administration. Baseline measurements were compared with intra-therapy measurements using paired t tests.
During the administration of magnesium sulfate, the fetal middle cerebral artery diastolic blood flow velocity decreased significantly (P = .05) and the maternal uterine artery diastolic blood flow velocity increased significantly (P = .01). There were no significant changes in the umbilical artery diastolic blood flow measurements. These findings remained the same after adjusting for gestational age, estimated fetal weight, frequency of contractions, serum magnesium level at the time of the intra-therapy Doppler study, and maternal blood pressure.
The alterations in fetal hemodynamics during magnesium sulfate administration suggest a physiologic normalization process related to the stressed preterm infant and the preterm labor process itself.
评估镁对接受硫酸镁治疗早产的母亲胎儿血流动力学的影响。
选取20名在妊娠24 - 35周出现早产并前往卡罗莱纳医疗中心就诊的女性纳入研究。在开始硫酸镁抑制宫缩治疗前及静脉给药期间，使用脉冲波多普勒对胎儿大脑中动脉、胎儿脐动脉和母亲子宫动脉进行测量。采用配对t检验将基线测量值与治疗期间测量值进行比较。
在硫酸镁给药期间，胎儿大脑中动脉舒张期血流速度显著降低（P = 0.05），母亲子宫动脉舒张期血流速度显著增加（P = 0.01）。脐动脉舒张期血流测量值无显著变化。在校正胎龄、估计胎儿体重、宫缩频率、治疗期间多普勒研究时的血清镁水平和母亲血压后，这些结果保持不变。
硫酸镁给药期间胎儿血流动力学的改变提示与应激早产婴儿和早产过程本身相关的生理正常化过程。
