Dosage of magnesium during pregnancy intravenous drip. Magnesium drip during pregnancy: side effects. Magnesia: indications for use

For the first time in obstetric practice, magnesium sulfate (magnesia) was used at the beginning of the last century as an anticonvulsant.

Since then, magnesium preparations have been widely used in medicine to prevent obstetric complications, improve the condition of pregnant women and to prevent magnesium deficiency in the body.

However, in recent years, alarming information has emerged that the active use of magnesia during pregnancy may pose a threat to the unborn baby.

Magnesia (magnesium sulfate, magnesium oxide, etc.) is a colorless powdery substance of natural origin that has found application in various areas of human activity.

In medicine, magnesium sulfate is used as a solution of 25% concentration, in a single dosage of 20–40 ml, as needed, or as a suspension for oral administration, previously prepared from powder.

Medical magnesia is a drug consisting of a single main component and does not contain any auxiliary substances. The range of indications for the use of magnesium sulfate is quite wide:

• hypertensive crisis (including the risk of a crisis);
• acute magnesium deficiency in the body (including the risk of developing acute hypomagnesemia during periods of increased need for magnesium);
• smooth muscle spasms;
• poisoning with toxic substances;
• the need to stimulate defecation (before medical procedures, etc.) and so on.

Moreover, achieving the desired effect from the effects of magnesium sulfate on the body depends on the form in which the patient takes the medicine: in the form of a suspension for swallowing or in the form of intramuscular or intravenous injections. During pregnancy, most often, there are indications for the injection of magnesium.

The list of contraindications to the use of magnesium sulfate solution and the risk of developing a negative effect of the drug on the body of a pregnant woman is quite large. In addition, there are strict procedural rules for introducing magnesium into the patient's blood. Therefore, magnesium sulfate injections should be carried out in a hospital setting.

Indications for the use of magnesia during pregnancy themselves require continuous medical supervision, therefore, the appointment of droppers or magnesium injections is carried out for expectant mothers undergoing inpatient treatment.

Why is Magnesia prescribed to pregnant women: for what period is the drug indicated?

The wide spectrum of action of magnesium sulfate, its effectiveness and relative safety for the mother and fetus, its availability and low cost make it possible to consider magnesium one of the most popular means in the treatment of pregnancy complications such as:

• caused by myometrial tone.

In this case, first of all, the effectiveness of magnesium sulfate as a tocolytic agent is important. Magnesium ions, acting as calcium channel blockers, reduce the ability of smooth muscles to spasm, eliminating uterine tone.

At the same time, the vasodilating effect of magnesium has a positive effect on the quality of blood circulation, including oxygen exchange in the “uterus-placenta-fetus” system;

• Hypomagnesemia is often the cause of excessive uterine tone during pregnancy.

Treatment of uterine hypertonicity with magnesium injections allows, among other things, to replenish the magnesium content in the body of a pregnant woman. Also, when there is a threat of premature birth, the sedative, calming effect of magnesia has a beneficial effect on the psychological state of the expectant mother;

In the early stages, magnesia is usually not prescribed to pregnant women.

Doctors consider it advisable to prescribe magnesium to maintain pregnancy from the second trimester of pregnancy, since in the early stages the risk of premature rejection of the fetus by the uterus is most often hormonal in nature.

• Serious complications of gestosis (with nephropathy, convulsive syndromes).

In the later stages, magnesium is indicated for use as a rapid response agent to relieve convulsive eclamptic seizures in the patient.

The drug-like effect of magnesia in certain doses inhibits the activity of the central and peripheral nervous system, including acting as an anesthetic.

Magnesia has a beneficial effect on heart rate and rhythm and has a hypotensive effect. In addition, magnesium stimulates the urinary process, thus reducing swelling in a patient with preeclampsia.

Forms of using Magnesia during pregnancy: injection or drop?

Indications for the use of magnesium sulfate during pregnancy require the receipt and presence of a certain concentration of the drug in the patient’s blood, which is impossible to achieve with oral administration. In addition, the consequences of taking magnesium if swallowed can provoke the development of contractile activity of the uterus.

Therefore, expectant mothers are usually prescribed injections of the drug:

• intramuscularly, in the form of injections;
• intravenously, by drip.

The effect of using magnesia in both cases is the same. Moreover, when the drug is administered intravenously, its effect begins immediately, since the drug immediately enters the woman’s blood. Whereas when administered intramuscularly, the drug begins to exhibit its properties within an hour after administration.

In recent years, doctors have given preference to the intravenous use of magnesia for pregnant women, since injections of the drug into the muscle are very painful, cause the formation of hematomas at the site of syringe insertion and require careful, unhurried execution of the procedure by the staff.

The exact dosage of magnesia should be calculated for you in the hospital. You should not give such injections at home, as this medicine has a number of serious side effects.

5-20 ml of 20-25% Magnesia solution must be administered by drip or injection per day. The course of treatment is 1 week.

Is Magnesia safe?

In many countries (including Russia), doctors often resort to long-term course use of magnesium sulfate in the treatment of pregnant women with.

Statements about the safety of such treatment for the fetus are based on the experience of previous generations, while there is no evidence of this from evidence-based medicine.

On the contrary, in the recent past, American scientists stated that a study of newborns whose mothers received long-term therapy with magnesium sulfate (more than 10 weeks) confirmed data on the negative intrauterine effects of magnesium on the fetus.

Skeletal abnormalities were noted in the observed infants, which scientists associate with hypocalcemia, which arose as a result of leaching of calcium from the fetal bones in the prenatal period due to attack by magnesium ions. However, pathological changes in bone tissue are apparently short-term and can be corrected.

Research on this matter continues, but Western doctors strongly recommend prescribing magnesium only in cases where the likely benefit of treatment outweighs the risk of adverse effects on the fetus and observing restrictions on the duration of therapy using magnesium sulfate in the treatment of expectant mothers.

The speed of administration of the drug to a pregnant woman is of no small importance. Magnesium ions freely penetrate the placenta, ending up in the fetal blood in the same concentration as in the mother’s blood.

Rapid intake of magnesium sulfate, especially during labor (for example, when treating eclampsia during labor, when trying to slow down premature labor, etc.) causes a decrease in blood pressure, respiratory depression, and disturbances in brain activity in the newborn, as a reaction to a sharp hypermagnesemia.

This can lead to death for the baby in utero or in the neonatal period.

If there is a need to use magnesium in the prenatal period, then, in order to avoid adverse effects of the drug on the fetus, the administration of magnesium sulfate is stopped at least 2 hours before the expected onset of labor, unless this threatens the life of the mother.

Side effect

Often, expectant mothers, receiving conservation therapy with magnesium, complain about certain changes in their well-being, quite rightly attributing them to the side effects of the drug, namely:

Contraindications for taking Magnesia during pregnancy

The use of magnesia in the treatment of a pregnant woman may be contraindicated under certain conditions:

• chronic arterial hypotension, or severe hypotension, as a reaction to the drug;
• severe kidney disease;
• intolerance to the drug (dangerous disturbances in the functioning of vital organs as a reaction to the drug).

In recent years, doctors have expressed mixed opinions regarding the use of magnesium sulfate in obstetric practice.

On the one hand, there is evidence of adverse effects of the drug on the mother's body and, to an even greater extent, on the well-being of the fetus.

On the other hand, many pregnancy complications for which magnesium is prescribed arise from a deficiency of magnesium in the body and are treatable when the substance is replenished.

The search for an ideal alternative to injectable magnesium sulfate continues. In the meantime, doctors strongly advise expectant mothers, even at the stage of pregnancy planning, to review their diet and, if necessary, include magnesium-containing supplements.

Most pregnant women are very wary of any medications that the doctor prescribes, trying to protect the unborn baby from their effects. A negative attitude towards pharmaceutical products is quite justified, since almost any box of pills contains a warning about a possible risk to the fetus or a lack of information about the effect of the medicine on the course of pregnancy. This is why many expectant mothers are distrustful even of prescribing magnesia injections during pregnancy for serious reasons.

Magnesium sulfate in the form of a medicinal solution has been successfully used in obstetrics for several decades. Despite this, magnesium injections during pregnancy are not suitable for everyone, so they are prescribed by doctors with extreme caution. Let's consider what effect the drug has, as well as the main indications for magnesium injections during pregnancy.

Magnesium sulfate for pregnant women: a cure for all ailments?

As early as the early 20th century, magnesia was used as a treatment for seizures. Later, magnesium sulfate injections began to be prescribed during pregnancy, since the drug had an excellent tocolytic effect, that is, it was able to relax muscles and reduce the tone of the uterus when there was a threat of premature birth. In addition, intravenous administration of magnesium in modern medicine is one of the primary actions in the development of severe preeclampsia and hypertensive crisis, as it helps lower blood pressure by normalizing the tone of arterial vessels.

IMPORTANT! In obstetrics, intramuscular injections of magnesium sulfate solution are practically not used, due to the pain and inconvenience of administering the drug in this way. A high therapeutic effect is provided by a magnesium dropper during pregnancy at the rate of: 20-25% solution in an amount of 5-20 ml per 150-200 ml of 0.9% NaCl solution for intravenous drip administration for several hours.

Magnesia injections during pregnancy are also prescribed for:

• edema syndrome, as well as urinary retention;
• epileptic seizures, convulsions during eclampsia;
• poisoning with salts of heavy metals;
• imbalance of microelements and lack of magnesium in the body;
• hypertensive crisis.

IMPORTANT! Magnesia injections during pregnancy can be prescribed from the 16th week until the end of the gestational age.

How dangerous are magnesium injections during pregnancy?

During all this time, large-scale clinical studies of the effect of magnesium sulfate on the fetus have not been conducted, but the experience of long-term use of the drug confirms its relative safety.

Despite the widespread use of various drugs during gestation, we should not forget that any of them is potentially dangerous. Take, for example, the well-known harmless paracetamol, which is prescribed from the first months of life: the drug causes an allergic reaction in many people, including anaphylactic shock. That is why the prescription of any pharmaceutical product during pregnancy must be justified. Usually on the packaging of magnesia injections for pregnant women it is written that the medicine is prescribed with caution, and only if the benefit outweighs the risk to the health of the fetus.

IMPORTANT! Due to the negative impact of long-term use of magnesia on the mineral metabolism of the fetus with the subsequent development of bone abnormalities due to a lack of calcium, the drug is prescribed during gestation for a period of three to seven days. The last administration of magnesium sulfate should be no later than a few hours before the onset of labor, as the drug relaxes the muscles of the uterus and prevents its active contraction.

In what cases are magnesium injections contraindicated during pregnancy?

The main contraindications to the use of the drug are directly related to its tocolytic, sedative, antispasmodic, anticonvulsant, diuretic and hypotonic effects. These include:

• low blood pressure (hypotension) and slow heart rate (bradycardia);
• severe kidney disease with impaired excretory function;
• cardiac conduction disorders, including AV block;
• respiratory failure due to depression of the respiratory center (consequences of head injury, anesthesia, drug overdose);
• cancer formation;
• acute course of diseases of the digestive system;
• the likelihood of labor starting in the next 2-3 hours;
• hypersensitivity to the drug.

What side effects should you expect after magnesium injections during pregnancy?

In rare cases, when administered magnesium, certain side effects may occur, including increased heart rate, sweating, fever, drop in blood pressure, weakness, and headache. As a rule, these symptoms appear when the dosage of the drug is incorrectly calculated or when it is administered quickly.

While carrying a baby in her tummy, a pregnant woman may more than once encounter a situation during the entire 9 months when she will need the help of a doctor and even treatment, and this may be related not only to her health. A woman in an interesting position is always wary of all medical procedures, as well as prescribed medications and medications, and this is understandable, because during pregnancy she is responsible not only for her own health, but also for her health, and sometimes for her life your unborn child. Among the huge list of drugs that are traditionally prescribed to pregnant women to maintain health and preserve the fetus, magnesium is far from the least important. Magnesia injections during pregnancy are a fairly common occurrence that expectant mothers encounter, especially if one of them bothers to stay in the hospital. Why do doctors prescribe magnesia, what role does it play in the development of the fetus, does this substance have contraindications, and how necessary is it to follow doctors’ instructions and give magnesium injections during pregnancy?

Magnesia injections during pregnancy. For what?

Magnesia and drugs such as magnesium sulfate and magnesium sulfate are the same substance that has certain properties that are beneficial to the body of a woman who is preparing to become a mother. Magnesia injections during pregnancy are excellent:

• prevent the possibility of developing complications during pregnancy;
• prevent the possibility of miscarriage;
• reduce the risk of premature birth;
• reduce the increased tone of the uterus, relax the muscles and walls of all blood vessels;
• bring blood pressure back to normal;
• remove excess fluid from the pregnant woman’s body, which helps remove and prevent swelling;
• slow down the process of blood clot formation;
• lower blood pressure;
• replenish the lack of magnesium;
• eliminate symptoms of gestosis, eclampsia, nephropathy and relieve seizures;
• improve the general condition and well-being of the pregnant woman.

Why injections?

Such a broad positive effect of magnesia on the body of a pregnant woman is possible only with its intramuscular and intravenous administration, because it is absorbed only through the blood. If you take this drug in powder or tablet form, you will not get anything other than a strong laxative effect. Magnesia injections during pregnancy are prescribed, as a rule, in the 2nd and 3rd trimester, while in the 1st trimester they are not recommended and are replaced with lighter ones: no-shpu and papaverine. The amount of magnesium sulfate needed for a pregnant woman, as well as its concentration, depends on the health of the woman and the condition of the fetus. As a rule, this is a 25% solution in an amount of 20 ml for one dose, prescribed either twice or four times a day. Intramuscular magnesium injections during pregnancy are a rather unpleasant and painful procedure, often provoking a feeling of numbness in the limb and even cramps. To slightly ease the pregnant woman’s feeling of pain and enhance the positive effect of a magnesium injection, the solution is first warmed and, always using a long needle, slowly injected into the femoral muscle. Intravenous injections are carried out for an even longer time. At the same time, the burning sensation in a vein that a pregnant woman may experience is considered normal. Often, a dropper is used to administer magnesium to pregnant women. This event is even longer (several hours), but practically painless. Sometimes, for more sensitive individuals, electrophoresis using magnesia is prescribed. But magnesium injections during pregnancy are still the most common manipulation, due to the simplicity and speed of its implementation. Therefore, in antenatal clinics and gynecological hospitals, injections are used in most cases.

Side effects.

There is no specific information about studies conducted on the negative effects of magnesia on the condition and development of the fetus in the womb. But many years of world experience in using this drug proves a positive effect on the child’s condition in the second half of pregnancy, when absolutely all of its organs are already formed, and the tone of the uterus and other health problems of the expectant mother are more dangerous than magnesia injections during pregnancy. However, some risks still exist, and a pregnant woman has the right to know about them. Magnesium sulfate has a number of side effects, namely:

• increased sweating;
• rush of blood outflow to the face;
• the likelihood of headaches;
• weakness and drowsiness, as well as groundless anxiety;
• irritability and nervousness;
• mild nausea and sometimes vomiting;
• drop in blood pressure;
• provokes a prenatal condition.

In addition, a pregnant woman should keep in mind that under no circumstances should magnesia injections be given during pregnancy if:

• you have low blood pressure;
• you use dietary supplements;
• take medications containing calcium;
• getting ready for childbirth.

A few hours before the onset of labor, magnesium sulfate must be discontinued. In fact, this drug only works when it is in the blood. Therefore, approximately 2 hours after administration of the drug, magnesia no longer prevents the opening of the cervix and the onset of labor.

Magnesia injections during pregnancy are an excellent way to get rid of uterine tone, thrombophlebitis, nephropathy,gestosis, swelling and a number of other problems that a pregnant woman may encounter. But the positive effect of this drug directly depends on its necessity, on the quantity and quality of its administration. Short-term use of magnesium is considered absolutely harmless and beneficial, but its excess can cause a number of unpleasant consequences and even impair the child’s breathing. Therefore, be sure to follow your doctors’ instructions and remember that treatment with magnesium sulfate preparations should only be carried out under their constant supervision and strict control.

Magnesia during pregnancy is widely used throughout the world for the treatment, first of all, of preeclampsia, eclampsia, premature birth and associated symptoms. Preeclampsia, also known as late-onset toxicosis, preeclampsia, or hypertension of pregnancy, is characterized by dangerously high blood pressure, protein in the urine, and swelling. In severe cases, the condition also leads to blurred vision, kidney failure, hemorrhages in the liver and intestines, placental abruption, and delayed fetal development. Preeclampsia can develop into eclampsia, when loss of consciousness occurs and convulsions begin, and also lead to a pathological change in the composition of the blood, which is deadly for the woman and child.

Long-term empirical and clinical data support the effectiveness of magnesium sulfate, however, questions remain about its safety and mechanism of action. In domestic obstetrics, Magnesia is used at the slightest suspicion of gestosis, with increased blood pressure and swelling, not to mention the appearance of protein in the urine, doctors suggest that pregnant women go to the hospital for preservation and undergo a course of treatment with the drug. But Western studies say that preeclampsia affects only 2-8% of all pregnancies, and accordingly, many women are prescribed the drug unjustifiably. So why is magnesium injected into pregnant women and why is it recommended to almost every second expectant mother?

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Magnesia - what is it

Magnesia is magnesium sulfate heptahydrate or magnesium sulfuric acid salt with the formula MgSO4*7H2O. The substance has another name - Epsom salt, as it was obtained at the end of the 17th century from the water of a mineral spring in the city of Epsom and was widely used in medicine, agriculture and industry. It has been used to treat seizures since 1906. Today this natural mineral can be found in any pharmacy in the form of a white powder or solution.

What is Magnesia used for during pregnancy?

Magnesia during pregnancy is prescribed as a multifactorial remedy with a wide spectrum of action:

• the vasodilating effect is aimed at the peripheral vascular network and cerebral circulation;
• protection of the blood-brain barrier;
• diuretic effect and protection against edema;
• anticonvulsant.

In the USA and Europe, droppers with Magnesia during pregnancy are prescribed for the prevention and treatment of preeclampsia and are most often prescribed in the 3rd trimester.

In Russia, the indications for the use of Magnesia are much wider:

• for edema during pregnancy as a diuretic;
• with symptoms of gestosis: high blood pressure, protein in the urine, swelling and cramps in severe cases;
• as a tocolytic – to relax the smooth muscles of the uterus and relieve tone;
• as a sedative;
• with a lack of magnesium;
• as a prophylaxis in cases of predisposition to blood clots;
• as part of complex therapy for placental abruption and fetal growth retardation syndrome.

What else is Magnesia used for during pregnancy? Magnesia also has laxative, antiarrhythmic, and choleretic properties. It has a protective effect on the child’s nervous tissue, protecting against cerebral palsy, and has a positive effect on metabolism, preventing low body weight in newborns.

In Russia, Magnesia is prescribed even in the early stages of pregnancy as a tocolytic agent for uterine tone, but in the 1st and 2nd trimesters, the use of the drug for this purpose is useless, since it acts on smooth muscles only during its contraction, that is, during contractions. Magnesium sulfate penetrates the placenta, so the use of magnesium during pregnancy in the first trimester is not only inappropriate, but also incomparable with the risks for fetal development.

Electrophoresis with magnesium is also often prescribed during pregnancy. On the one hand, this allows the substance to be delivered directly to the uterus, but on the other hand, late toxicosis and convulsions are contraindications to the procedure. Thus, electrophoresis can be used exclusively as a means of prevention at a high risk of gestosis, but not for its direct treatment.

Release forms

Magnesium sulfate is produced by various pharmaceutical companies, but there are only two dosage forms:

• powder for preparing a suspension that is taken orally;
• solution 25% for intramuscular and intravenous administration in the form of ampoules of 5 or 10 ml.

Features of treatment and dosage

There are 3 ways to administer Magnesia into the body during pregnancy - intravenously, intramuscularly and orally:

1. A 25% solution is taken orally as a laxative and choleretic agent.
2. Magnesia injections are rarely used during pregnancy, as they are quite painful, and the drug requires slow administration - the first 3 ml over three minutes. Pregnant women are mostly injected intramuscularly with magnesium by emergency doctors for dangerously high blood pressure, for which they mix the drug with an anesthetic.
3. The intravenous solution is administered slowly, 5-20 ml up to 2 times a day, since too rapid entry of magnesium into the body can provoke severe hypotension and oxygen starvation of the fetus. The exact dosage and duration of treatment with Magnesia during pregnancy is prescribed individually depending on the patient’s condition, but most often it is a weekly course.

The line between a therapeutic and a toxic dose of magnesium sulfate is very thin. The more drug administered, the greater the likelihood of serious side effects, therefore, when using magnesia, it is necessary to monitor the patient’s condition: cardiac and pulmonary activity, electrolyte balance using urine and blood tests.

Magnesium sulfate is taken only as prescribed by a doctor and its interaction with other drugs is taken into account. Magnesia is a calcium antagonist, so calcium gluconate or calcium chloride eliminates the effect of the drug that is used in case of overdose, and calcium and magnesium preparations are injected into different veins. Diuretics can cause hypo- or hypermagnesemia. Caution is necessary when taking CNS depressants concomitantly. Use Magnesia with special care for kidney diseases and limit the dose to 20 mg for 48 hours.

Side effects

Magnesium sulfate is classified as a drug category D. There is evidence of risk to the fetus, but the potential benefits of using the drug in pregnant women in certain situations may outweigh these risks.

Possible complications for the child:

1. Newborns may show signs of magnesium toxicity (difficulty breathing or neuromuscular depression) if the mother was given intravenous drips shortly before birth during pregnancy.
2. Some studies show that Magnesium use is associated with decreased blood flow through brain tissue in premature babies. However, magnesium sulfate does not lead to a significant decrease in Apgar scores in newborns, even with a significant excess of magnesium in their blood.
3. Long-term intravenous administration, for example, with tocolysis, can lead to persistent hypocalcemia and congenital rickets in the fetus.
4. The combination of prenatally acquired magnesium sulfate and the antibiotic gentamicin (administered after birth, passes into breast milk) can lead to respiratory depression in newborns.

In fact, Magnesia is more toxic to the mother's body than to the baby in the womb.

According to the instructions, side effects of Magnesia during pregnancy may include:

• decreased heart rate, sweating, depression of cardiac activity, nerve and muscle conduction;
• headache;
• anxiety;
• weakness;
• dizziness;
• nausea and vomiting, increased urine production (with too rapid intravenous/intramuscular administration or ingestion);
• flatulence, stomach cramps, thirst (if taken orally);
• the most dangerous complications are respiratory failure and pulmonary edema.

Magnesia is an effective option for the treatment and prevention of eclampsia and accompanying edema and high blood pressure. It is also used as a sedative, tocolytic, and when taken orally, as a laxative. Its mechanism of action covers both vascular and neurological systems, relieving dangerous symptoms of gestosis and reducing anxiety. The drug crosses the placenta and affects the fetus, but when prescribed for real indications, its benefit outweighs the possible risk.

Olga Rogozhkina

midwife

Magnesia is used to treat pregnancy pathologies exclusively in a hospital setting. Short-term and strictly dosed use of Magnesia is considered safe in late pregnancy for both the expectant mother and her child. That is, in the early stages this drug is contraindicated. Even if there is a threat of miscarriage in the first trimester, it is strongly recommended to maintain pregnancy with other medications. This is explained by the fact that scientific research on the effects of Magnesia on the fetus has not been carried out in full, and at the beginning of any pregnancy, when all the systems and organs of the fetus are being laid and formed, any medications should be limited as much as possible.

Useful video about the activities necessary to maintain pregnancy

For the first time in obstetric practice, magnesium sulfate (magnesia) was used at the beginning of the last century as an anticonvulsant for severe complications of gestosis.

Since then, magnesium preparations have been widely used in medicine to prevent obstetric complications, improve the condition of pregnant women and to prevent magnesium deficiency in the body.

However, in recent years, alarming information has emerged that the active use of magnesia during pregnancy may pose a threat to the unborn baby.

What is Magnesia

Magnesia (magnesium sulfate, magnesium oxide, etc.) is a colorless powdery substance of natural origin that has found application in various areas of human activity.

In medicine, magnesium sulfate is used as a solution of 25% concentration, in a single dosage of 20–40 ml, as needed, or as a suspension for oral administration, previously prepared from powder.

Medical magnesia is a drug consisting of a single main component and does not contain any auxiliary substances. The range of indications for the use of magnesium sulfate is quite wide:

• hypertensive crisis (including the risk of a crisis with arterial hypertension);
• acute magnesium deficiency in the body (including the risk of developing acute hypomagnesemia during periods of increased need for magnesium);
• convulsive syndromes;
• smooth muscle spasms;
• poisoning with toxic substances;
• the need to stimulate bowel movements (for constipation, before medical procedures, etc.) and so on.

Moreover, achieving the desired effect from the effects of magnesium sulfate on the body depends on the form in which the patient takes the medicine: in the form of a suspension for swallowing or in the form of intramuscular or intravenous injections. During pregnancy, most often, there are indications for the injection of magnesium.

The list of contraindications to the use of magnesium sulfate solution and the risk of developing a negative effect of the drug on the body of a pregnant woman is quite large. In addition, there are strict procedural rules for introducing magnesium into the patient's blood. Therefore, magnesium sulfate injections should be carried out in a hospital setting.

Indications for the use of magnesia during pregnancy themselves require continuous medical supervision, therefore, the appointment of droppers or magnesium injections is carried out for expectant mothers undergoing inpatient treatment.

Why is Magnesia prescribed to pregnant women: for what period is the drug indicated?

The wide spectrum of action of magnesium sulfate, its effectiveness and relative safety for the mother and fetus, its availability and low cost make it possible to consider magnesium one of the most popular means in the treatment of pregnancy complications such as:

• threat of premature birth caused by myometrial tone.

In this case, first of all, the effectiveness of magnesium sulfate as a tocolytic agent is important. Magnesium ions, acting as calcium channel blockers, reduce the ability of smooth muscles to spasm, eliminating uterine tone.

At the same time, the vasodilating effect of magnesium has a positive effect on the quality of blood circulation, including oxygen exchange in the “uterus-placenta-fetus” system;

• Hypomagnesemia is often the cause of excessive uterine tone during pregnancy.

Treatment of uterine hypertonicity with magnesium injections allows, among other things, to replenish the magnesium content in the body of a pregnant woman. Also, when there is a threat of premature birth, the sedative, calming effect of magnesia has a beneficial effect on the psychological state of the expectant mother;

In the early stages, magnesia is usually not prescribed to pregnant women.

Doctors consider it advisable to prescribe magnesium to maintain pregnancy from the second trimester of pregnancy, since in the early stages the risk of premature rejection of the fetus by the uterus is most often hormonal in nature.

• Serious complications of gestosis (with nephropathy, convulsive syndromes).

In the later stages, magnesium is indicated for use as a rapid response agent to relieve convulsive eclamptic seizures in the patient.

The drug-like effect of magnesia in certain doses inhibits the activity of the central and peripheral nervous system, including acting as an anesthetic.

Magnesia has a beneficial effect on heart rate and rhythm and has a hypotensive effect. In addition, magnesium stimulates the urinary process, thus reducing swelling in a patient with preeclampsia.

Forms of using Magnesia during pregnancy: injection or drop?

Indications for the use of magnesium sulfate during pregnancy require the receipt and presence of a certain concentration of the drug in the patient’s blood, which is impossible to achieve with oral administration. In addition, the consequences of taking magnesium if swallowed can provoke the development of contractile activity of the uterus.

Therefore, expectant mothers are usually prescribed injections of the drug:

• intramuscularly, in the form of injections;
• intravenously, by drip.

The effect of using magnesia in both cases is the same. Moreover, when the drug is administered intravenously, its effect begins immediately, since the drug immediately enters the woman’s blood. Whereas when administered intramuscularly, the drug begins to exhibit its properties within an hour after administration.

In recent years, doctors have given preference to the intravenous use of magnesia for pregnant women, since injections of the drug into the muscle are very painful, cause the formation of hematomas at the site of syringe insertion and require careful, unhurried execution of the procedure by the staff.

The exact dosage of magnesia should be calculated for you in the hospital. You should not give such injections at home, as this medicine has a number of serious side effects.

5-20 ml of 20-25% Magnesia solution must be administered by drip or injection per day. The course of treatment is 1 week.

Is Magnesia safe?

In many countries (including Russia), doctors often resort to long-term course use of magnesium sulfate in the treatment of pregnant women with uterine tone.

Statements about the safety of such treatment for the fetus are based on the experience of previous generations, while there is no evidence of this from evidence-based medicine.

On the contrary, in the recent past, American scientists stated that a study of newborns whose mothers received long-term therapy with magnesium sulfate (more than 10 weeks) confirmed data on the negative intrauterine effects of magnesium on the fetus.

Skeletal abnormalities were noted in the observed infants, which scientists associate with hypocalcemia, which arose as a result of leaching of calcium from the fetal bones in the prenatal period due to attack by magnesium ions. However, pathological changes in bone tissue are apparently short-term and can be corrected.

Research on this matter continues, but Western doctors strongly recommend prescribing magnesium only in cases where the likely benefit of treatment outweighs the risk of adverse effects on the fetus and observing restrictions on the duration of therapy using magnesium sulfate in the treatment of expectant mothers.

The speed of administration of the drug to a pregnant woman is of no small importance. Magnesium ions freely penetrate the placenta, ending up in the fetal blood in the same concentration as in the mother’s blood.

Rapid intake of magnesium sulfate, especially during labor (for example, when treating eclampsia during labor, when trying to slow down premature labor, etc.) causes a decrease in blood pressure, respiratory depression, and disturbances in brain activity in the newborn, as a reaction to a sharp hypermagnesemia.

This can lead to death for the baby in utero or in the neonatal period.

If there is a need to use magnesium in the prenatal period, then, in order to avoid adverse effects of the drug on the fetus, the administration of magnesium sulfate is stopped at least 2 hours before the expected onset of labor, unless this threatens the life of the mother.

Side effect

Often, expectant mothers, receiving conservation therapy with magnesium, complain about certain changes in their well-being, quite rightly attributing them to the side effects of the drug, namely:

• rapid heartbeat, arrhythmia;
• hypotension;
• confusion, slow reflexes;
• increased sweating, feeling hot;
• attacks of nausea and vomiting;
• unpleasant reaction from the gastrointestinal tract;
• disturbance of visual perception;
• severe muscle weakness;
• headaches, fainting.

Such manifestations indicate an excess of magnesium concentration in the body at the moment and may require a slow release of the drug into the blood.

Significant hypermagnesemia due to an incorrectly established regimen for taking magnesium can cause serious deviations in the functioning of the vital centers of a pregnant woman. Therefore, when carrying out procedures with the infusion of magnesium sulfate into the blood, expectant mothers are monitored for breathing rate, the presence of a knee reflex, and the quality of diuresis, allowing timely detection of a magnesium overdose.

Contraindications for taking Magnesia during pregnancy

The use of magnesia in the treatment of a pregnant woman may be contraindicated under certain conditions:

• chronic arterial hypotension, or severe hypotension, as a reaction to the drug;
• severe kidney disease;
• intolerance to the drug (dangerous disturbances in the functioning of vital organs as a reaction to the drug).

In recent years, doctors have expressed mixed opinions regarding the use of magnesium sulfate in obstetric practice.

On the one hand, there is evidence of adverse effects of the drug on the mother's body and, to an even greater extent, on the well-being of the fetus.

On the other hand, many pregnancy complications for which magnesium is prescribed arise from a deficiency of magnesium in the body and are treatable when the substance is replenished.

The search for an ideal alternative to injectable magnesium sulfate continues. In the meantime, doctors strongly advise expectant mothers, even at the stage of pregnancy planning, to review their diet and, if necessary, include magnesium-containing supplements.

For most women, the pregnancy period is both joyful and difficult at the same time. The growth and development of new life inside the female womb creates a lot of physiological changes, which, unfortunately, do not always occur without side effects in terms of the well-being of the expectant mother.

Many troubles arise, including the threat of miscarriage and excessive or insufficient weight gain, both by the mother and the child. At the level of physical changes, blood pressure may increase, blood composition may change, low hemoglobin, and a lack of magnesium, calcium and other microelements may occur. All this creates a lot of discomfort for the expectant mother and causes depression.

When a girl or woman in pregnancy consults a doctor with similar symptoms, she may be recommended magnesium during pregnancy.

What is a magnesium drip and what is it for?

To understand what kind of drug this is, you will have to mentally go back a little to your school years and remember your chemistry lessons. So, magnesia is nothing more than a magnesium salt of sulfuric acid. That is, the drug that is used to call magnesia - magnesium sulfate - does not contain any unnecessary components. This is a white crystalline powdery substance, quite widely used in various fields of medicine.

Magnesia is used both in powder and soluble liquid form in gynecology, gastroenterology and neurology. This versatile use is explained by the fact that this drug can have different effects on the human body. It all depends on exactly how magnesium will be introduced as a drug into your body. The question remains, why do pregnant women need a magnesium dropper?

Properties of magnesia

Before talking about specific medical prescriptions, it is worth listing the medicinal properties of magnesia. So, this drug is capable of:

1. Anesthetize many painful sensations.

2. Expand narrowed vessels and improve blood flow.

3. Create antispasmodic and tocolytic reactions in the body.

4. Normalize arrhythmic impulses and stabilize the functioning of the heart as a whole.

5. Relieve cramps.

6. Increase the bile formation process in the body.

7. Laxative and diuretic effects.

8. Calm and have a positive effect on the nervous system.

The list of advantages of magnesia can be endless. However, we are more interested in which of its excellent qualities magnesium can help a woman during pregnancy. This is what we have to figure out.

In what form can magnesia be used by pregnant women? Typically, the drug is prescribed to pregnant women in the form of injections and droppers, although there are exceptions. But let's talk about everything in order.

In what cases is magnesia prescribed to pregnant women?

There can be many reasons for an appointment. For example, when a woman is diagnosed with a threat of miscarriage, when the expectant mother suffers from hypertension and there is a frequent threat of recurrence of periodic crises, when there is serious swelling of the limbs and face. The drug is also prescribed when stagnation or convulsions occur in the body.

When a woman has somehow been exposed to heavy metal poisoning such as arsenic, lead or mercury. When there is a threat of epileptic seizures and so on. In all these and many other cases, pregnant women are prescribed magnesium sulfate.

It is permissible to administer this drug to a pregnant woman either intravenously or intramuscularly. Because the powder form, even when dissolved in water, will not bring the desired result, since once it enters the stomach, it does not enter the bloodstream and can only be used as a laxative. But magnesium sulfate during pregnancy can dilate blood vessels when the situation requires it.

Special cases

It is impossible not to mention those special situations when it is impossible to do without magnesium. Such a case can be called a serious situation in which there is a risk of premature birth. This usually happens when the tone of the uterus is increased significantly and strong contractions can occur, which can provoke early labor. In this situation, magnesium is administered slowly intravenously and this is how doctors normalize the tone of the uterus.

Also, such a simple procedure as a dropper of magnesium during pregnancy can dilate the blood vessels of the brain, which tend to narrow with increased pressure. That is, when there is nausea, dizziness, pressure changes and a feeling of pressure on the head, then magnesium injections during pregnancy can expand the walls of excessively narrow vessels and bring the pressure back to normal.

Contraindications

In addition to its positive properties, magnesium during pregnancy can also enhance negative processes, since it still has contraindications. If, for example, the expectant mother has diseases of the digestive tract, the drug magnesium sulfate can provoke an exacerbation.

May cause unwanted diarrhea, nausea, thirst and flatulence, and even vomiting. You should also not take magnesium during pregnancy if you have been diagnosed with kidney failure.

Magnesia for pregnant women can also improve such disorders as electrolyte balance in the body. In this case, such troubles as convulsions, arrhythmia, confusion, asthenic reactions, and increased fatigue may appear.

Little known facts

Not all people know that magnesium sulfate is an excellent remedy for pain relief and neutralization of bruises and bruises, which can be eliminated by making regular magnesium compresses. You only need to hold the compress for 10 minutes until you feel a tingling sensation. This procedure will help you get rid of pain from falls and bruises.

Thus, to summarize, we can say that magnesia during pregnancy, a rather strong drug in terms of effects, and its uncontrolled use can not only not improve, but significantly worsen the condition of a pregnant woman. There is only one conclusion - listen to your doctor and do not make independent prescriptions for yourself.

If in your case, magnesium can really help you, a doctor will certainly prescribe it for you, and if not, then you shouldn’t take this drug! Do not neglect medical advice, do not self-medicate!

Have a good pregnancy and successful birth!

Not all women experience pregnancy without complications and pathologies. But if any violations have been identified, do not immediately panic and worry: modern medicine is well developed to successfully cope with many problems.

Magnesia is a popular drug often used in the treatment of pregnancy pathologies. It is prescribed both intramuscularly and intravenously. A number of doctors believe that magnesia during pregnancy can have a negative effect on the fetus, however, the use of the medicine is justified.

What is magnesium, what does it help with and how dangerous is it for the mother and fetus?

When is magnesium sulfate prescribed?

Magnesia (magnesium sulfate) can be prescribed when there is a magnesium deficiency, uterine hypertonicity, threat of miscarriage or premature birth, high blood pressure, swelling, gestosis during pregnancy, predisposition to thrombophlebitis, eclampsia (severe toxicosis in the second half of pregnancy). This medicine must be prescribed by a gynecologist.

Magnesium sulfate helps remove fluid from the body.

When treating with Magnesia, intramuscular or intravenous administration is used. The dose of the drug depends on the condition of the pregnant woman. Most often, a 25% solution of Magnesia is prescribed with a single dose of 20 milliliters. Intramuscular magnesium injections are quite painful. If the injection is done incorrectly, the injection site may become inflamed. Before the injection, you need to warm the solution and be sure to use a long needle. The drug must be administered very slowly: both intramuscularly and intravenously.

The effect of magnesium on the body of a pregnant woman

The effects of the drug administration observed in the body of a pregnant woman:

• pronounced calming effect;
• reduction in blood and intracranial pressure;
• prevention of leg cramps and generalized convulsive syndrome;
• reducing the severity of tachycardia in a pregnant woman and possible tachyarrhythmias (rhythm disturbances accompanied by increased heart rate);
• diuretic;
• decongestant.

With a severe deficiency of magnesium, the body of a pregnant woman cannot function normally. The usual requirement is 400 mg of a microelement per day, and during pregnancy you need 2 times more (10 mg per kg of a woman’s weight).

As a rule, a person receives the main amount of magnesium from water and food, but during pregnancy this becomes insufficient. Especially if there are factors that reduce magnesium intake: poor diet, deterioration of food absorption, low body temperature, increased physical activity.

Depression during pregnancy

Not a rare condition. Bad mood can be easily overcome without taking medications.

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Magnesium deficiency can be easily compensated by taking tablets. However, during pregnancy complications, when you need to quickly compensate for the lack of a microelement, you cannot do without a solution of magnesium sulfate for injection.

Is the drug safe?

It makes sense to talk about a number of risks that are associated with the intake of magnesium sulfate. First of all, we are talking about multiple side effects - vomiting, drowsiness, flushing, sweating, weakness, headaches, decreased blood pressure, speech impairment.

In addition, the administration of magnesia is strictly prohibited for persons with low blood pressure.

If after administration of the drug the expectant mother's blood pressure decreases, this is a good reason to discontinue magnesia.

Magnesia should not be combined with calcium supplements or biological food additives.

Also, a contraindication to the administration of magnesium is a prenatal condition: magnesium sulfate must be discontinued before childbirth. After the drug is removed from the blood, its effect ceases, and it will no longer interfere with the opening of the cervix.

Effect on the fetus

A course of magnesium (magnesium sulfate) lasting more than five to seven days when prescribed to a pregnant woman has a high risk of negative effects on fetal bone tissue.

According to experts, the danger of a long course of magnesium during pregnancy is associated with the removal of calcium from the body. This process can lead to osteopenia, or decreased bone density, in the fetus, and may lead to bone fractures in the child in the future.

This warning is based on 18 cases that were described in the medical literature in which newborns had skeletal abnormalities caused by osteopenia, including multiple fractures of long bones and ribs. Their mothers received magnesium for an average of 9.6 weeks during pregnancy at an average dose of 3,700 mg to prevent preterm birth. Scientists explain that such consequences may be caused by hypermagnesemia and subsequent hypocalcemia in the fetus.

Also, the danger of long-term use of magnesia by a pregnant woman is confirmed by the results of studies that recorded a statistically significant increase in the rate of bone abnormalities in newborns whose mothers took the drug for more than a week, compared with those who were exposed to it in the prenatal period for less than three days.

Is it dangerous to drink

paracetamol during pregnancy

Each woman decides for herself whether or not to take medications during this period, but there are still a number of drugs that are completely safe for health.

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The researchers also recorded differences in the levels of magnesium, calcium, phosphorus and osteocalcin in the blood immediately after birth in infants whose mothers received magnesium during pregnancy and in those who did not take it at all.

1. docteka.ru
2. ipregnancy.ru
3. onwomen.ru
4. clinical-pharmacy.ru

Magnesium sulfate, magnesium sulfate or MgSO4 is a drug used with great success in obstetrics for more than a hundred years. Obstetricians around the world love magnesium for its safety, effectiveness and low cost. In our article we will talk specifically about sulfate magnesia, during pregnancy used intravenously or intramuscularly. Unlike tablet magnesium preparations, magnesia is used to treat some acute conditions of the expectant mother and fetus.

Why is magnesium sulfate prescribed?

First you need to understand what functions magnesium performs in the body.

1. Magnesium ions directly regulate the transmission of nerve impulses along nerve fibers. With insufficient amounts of magnesium, convulsive conditions occur. A striking example of magnesium deficiency is insomnia, nervous excitability, and emotional lability.
2. The second important task of magnesium is the regulation of muscle tone, both skeletal, uterine and cardiac. When there is insufficient intake or high consumption of magnesium, which quite often happens in pregnant women, convulsive twitching occurs in the calf muscles. Also, a lack of magnesium causes vasospasm, increased blood pressure and contributes to pregnancy losses.

As we can see, in obstetrics there are quite a lot of points of application for magnesium preparations. However, if problems with insomnia or leg cramps are easily solved with tableted magnesium preparations, then such acute conditions as threatened loss of pregnancy or severe forms of gestosis require the use of magnesium sulfate parenterally (drops or intramuscular, i.e. injections) by route.

The main actions of magnesium used in obstetrics

Let's look at the beneficial properties of magnesia that help cope with acute situations:

1. Sedative or calming effect;
2. Mild narcotic and analgesic effect;
3. Vasodilator and antihypertensive effect;
4. Pronounced anticonvulsant effect;
5. Protective effect on the heart muscle and brain - both in the mother and in the fetus.

Indications for magnesium therapy

In modern obstetrics, there are two main indications for the use of the drug MgSO4.

The first is the threatening loss of pregnancy. This includes both threatened miscarriage in the first trimester of pregnancy and threatened premature birth in later stages.

I would like to draw your attention to the fact that recent studies of the mechanism of premature birth call into question the role of contractions and hypertonicity of the uterus. More and more researchers are talking about the role of special proteins and antigens in the cervix, which are provocateurs for the initiation of pregnancy loss processes.

However, despite these studies, magnesium therapy continues to be used in preterm labor to protect the fetal nervous system, calm and relieve pain for the mother, and improve fetal-uterine blood flow.

Namely, its severe forms associated with high blood pressure and convulsive syndrome - preeclampsia and eclampsia - are the second indication for the use of magnesia. Over the many years of using magnesia, this indication has never been doubted. Since magnesium ions relax the walls of blood vessels, this action is successfully used for a pronounced but gentle reduction in pressure. And the calming and anticonvulsant effect of magnesium helps to cope with convulsive syndrome.

How many days do you take magnesium drops during pregnancy?

As a rule, magnesium is administered intravenously. The initial dose of the drug is 2-4 grams of dry powder, diluted in a glucose solution or any saline solution for infusion. During pregnancy, this dose is administered slowly (over 15-20 minutes) using a syringe or dropper. Such emergency care can be provided to a pregnant woman almost anywhere: in a antenatal clinic, in the office of any doctor or paramedic, in an ambulance.

Most often, at the initial stages, the drug is administered using special devices - infusion pumps. These devices are small suitcases with a dropper system capable of administering the drug in certain doses at a given speed. This is very convenient because there is no need to count drops, and the likelihood of overdose is minimal.

The duration of use of magnesia is absolutely individual and depends on the severity of the woman’s condition.

Sometimes, for example, in cases of severe gestosis or irreversible premature birth, the drug is used within 24 hours to stabilize the condition and subsequent delivery.

In other cases - with moderate severity of gestosis - it is possible to stabilize the patient's condition. In this case, pregnancy can be continued, and the administration of magnesium sulfate continues in the form of one-time droppers or intramuscular injections for 5-10 days.

Side effects and contraindications

Unfortunately, not a single drug, even the safest one, can have nuances in its use. There are quite a few contraindications to the use of magnesium and they are rare in pregnant women requiring magnesium therapy:

1. Marked decrease in blood pressure.
2. Marked slowing of heart rate - .
3. Severe renal failure.

Of course, the drug, especially when administered in such large doses, has side effects:

1. Dizziness, weakness, lethargy, headache.
2. Double vision, visual disturbances.
3. Nausea, vomiting.
4. Redness of the face, hot flashes.
5. Sweating.

Against the background of adequately calculated doses of magnesium, such effects are insignificantly expressed, and the benefits of magnesium terrier are many times greater than the harm. The use of magnesium sulfate has saved thousands of mothers and children's lives over the years.

Alexandra Pechkovskaya, obstetrician-gynecologist, website specially for the site

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