Magnesium Sulfate for Preeclampsia

Preeclampsia is a pregnancy related complication characterized by high blood pressure and dysfunctional organs. It can be life-threatening for both the mother and the baby if not identified and treated in time. This disease usually presents after 20 weeks of pregnancy, and doctors often prescribe magnesium sulfate for preeclampsia.

How Is Magnesium Sulfate Used for Preeclampsia? 

Pregnant women with preeclampsia are at a very high risk of having seizures. Magnesium sulfate is a mineral which is very effective to reduce the risk of seizures. It is given intravenously and starts working as soon as it enters the blood stream. The infusion is continued for at least 24 hours after the delivery. If preeclampsia is severe, an urgent delivery is often needed, while the magnesium sulfate solution infusion can delay this need for up to two days. During this time the corticosteroid injections can help to mature the baby’s lungs for a better delivery.

How Does It Work?

In people with preeclampsia, the blood vessels in the brain are constricted, leading to cerebral ischemia and seizures. Magnesium sulfate works by dilating these blood vessels, which can improve the blood supply to the brain. It also alters the neuromuscular transmission and blocks the entry of calcium into synaptic endings, which makes the neurons less excitable and lowers the chance to have seizures.

How Effective Is It?

The effectiveness of magnesium sulfate for preeclampsia is well documented. It can greatly reduce the chances of developing eclampsia and maternal death. Patients who received magnesium sulfate were 67% and 52% less likely to have repeated convulsions as compared to those who received phenytoin or diazepam.

The main goal of treatment in preeclampsia is to prevent its progression to eclampsia and to reduce the risk of maternal mortality. Patients treated with magnesium sulfate have a 58% lower risk of developing full blown eclampsia as compared to those who do not receive this treatment. The rate of maternal mortality for women who received magnesium sulfate is also very low.

Side Effects of Magnesium Sulfate for Preeclampsia

Like every medicine, magnesium sulfate also has some side effects and must be administered with caution. There is a risk of overdose which can lead to magnesium toxicity, and this is fatal for both mother and the child. Some symptoms of magnesium sulfate overdose include:

  • Slow pulse or irregular heart beat
  • Nausea, vomiting, diarrhea
  • Difficulty in breathing
  • Low blood pressure
  • Kidney damage
  • Confusion
  • Low levels of calcium in blood
  • Heart attack

The ill effects are not confined to the mother and the baby can have floppiness or low muscle tone caused by low bone density. Severe toxicity can be fatal.

Other Treatment for Preeclampsia

The only cure for preeclampsia is delivery of the baby. This option is not possible sometimes because the pregnancy is still in early stages and the baby is not fully developed. In these cases, the treatment depends upon the severity of symptoms and the stage of pregnancy. Here are a few treatment options for preeclampsia.

1.      Medications

  • Medications to lower blood pressure: High blood pressure is the hallmark of preeclampsia. There are some antihypertensive medications which are safe during pregnancy. The aim is to keep the blood pressure around 140/90 mm Hg. Your obstetrician is the best person to decide whether you need any medicines and if you do, which one is best for you.
  • Corticosteroids: Severe preeclampsia can cause HELLP syndrome which can lead to liver failure. Corticosteroids are prescribed in this condition to improve the liver function.

Note: The HELLP syndrome refers to a group of symptoms:

  • H: hemolysis (the breakdown of red blood cells)
  • EL: elevated liver enzymes
  • LP: low platelet count

2.      Hospitalization

Hospitalization for monitoring the blood pressure and the well-being of the baby is recommended in severe cases of preeclampsia. Non stress testing for baby’s heart rate is done. The baby’s growth and levels of amniotic fluid are also measured by ultrasound scans. Low levels of amniotic fluid mean a poor blood supply to the baby and it needs to be addressed.  

4.      Delivery

Delivery of the baby is the definitive treatment for preeclampsia, and if it is diagnosed at later stage of pregnancy, your doctor may decide to deliver the baby as soon as possible. It can either be a C section or a normal delivery. A normal delivery is often induced depending upon the circumstances and the severity of preeclampsia. The magnesium sulfate for preeclampsia seizure prevention is usually started during the delivery.

The blood pressure usually returns back to normal in ten to twelve weeks following delivery. Be careful during this time and do not take nonsteroidal anti-inflammatory medicines for pain relief as these can elevate blood pressure. Acetaminophen (Tylenol) is a safe and better option. 

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