2017 TOG
Cerebral palsy (CP) is a general term describing a range of non-progressive syndromes of posture and motor impairment that result from an insult to the developing central nervous system.
It is the most common cause of severe physical disability in childhood. The characteristic
signs are spasticity, movement disorders, muscle weakness, ataxia and rigidity.
The link between preterm birth and perinatal fetal brain injury
Proposed mechanism of action of magnesium sulfate (MgSO4) for neuroprotection
One widely cited theory for the possible neuroprotective effect of MgSO4 is that, by blocking calcium processes and thus acting as a vasodilator, it may inhibit or delay ischemic cell death during and after cerebral ischaemic events.
Randomised controlled trials
Conclusion
MgSO4 probably has a modest neuroprotective effect which is greater the earlier the gestational age of the infant at delivery and is currently recommended for use in preterm deliveries less than 30-32 weeks of gestation (guided by local policy).
When administered at an appropriate dose and with proper monitoring, there is no evidence of harm to the fetus, neonate or mother.
The optimum timing, dose and duration of its administration remains undefined by large studies.
however, most guidelines recommend its use within 4 hours of delivery and for a maximum of 24 hours using the standard pre-eclampsia toxaemia regimen.
A study is underway in Australia to assess gestation-specific benefit between 30 and 34 weeks of gestation.
About the Author
