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MgSO4

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  • 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

    • Monitor reflexes, vital signs, urine output regularly

  • 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

 

 

Reference: Magee LA, Smith GN, Bloch C, et al. Guideline No. 426: Hypertensive Disorders of Pregnancy: Diagnosis, Prediction, Prevention, and Management. J Obstet Gynaecol Can. 2022;44(5):547-571.e1. doi:10.1016/j.jogc.2022.03.002

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