A review of the role for magnesium sulphate in preterm labour

During the last decade, the body of medical knowledge concerning the use of pharmacological doses of magnesium sulphate (MgSO(4)) for preterm labour has increased substantially. Several randomised controlled trials (RCTs) have provided compelling evidence that MgSO(4) is the drug of choice for maternal seizure prophylaxis in pre-eclampsia, whether preterm or term. In contrast, a recent Cochrane systematic review of the relevant contemporary literature has found no evidence basis to support the use of MgSO(4) for tocolysis in preterm labour. Furthermore, associated with high-dosage tocolytic MgSO(4), recent data indicate a possible increased risk for neonatal intraventricular haemorrhage (IVH), as well as increased total paediatric mortality. It is possible, on the other hand, that the prophylactic administration of much lower dosages of MgSO(4), in selected cases of preterm labour, may have a neuroprotective effect for a small number of infants.