MgSO4

  • 1st line tx of eclampsia

  • Prophylaxis against eclampsia if severe preeclampsia

  • Consider for prophylaxis if non-severe preeclampsia with: severe HTN, headache, visual symptoms, RUQ pain, epigastric pain, plt <100, progressive renal insufficiency, and/or elevated liver enzymes

  • Dose: 4g IV loading dose then 1g/hr

    • No routine monitoring of Mg levels

  • No phenytoin or BDZs for eclampsia prophylaxis or tx unless contraindications to MgSO4 or MgSO4 is ineffective

  • If pre-existing or gestational HTN, consider MgSO4 for fetal neuroprotection if imminent preterm birth (w/in 24 hrs) @ ≤31+6 wks gest

    • Don’t delay delivery to give MgSO4 if maternal and/or fetal indications for emergency delivery

 

 

Adapted from SOGC Clinical Practice Guideline. Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy: Executive Summary. J Obstet Gynaecol Can 2014;36(5):416–438