Common premature labor treatment may be ineffective

AORN Journal,  Jan, 2007  

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The use of IV magnesium sulfate to inhibit uterine contractions (ie, tocolysis) is one of the most common treatments in North America for delaying premature labor, but this treatment may not be effective and may cause fetal and neonatal deaths, according to a Sept 29, 2006, news release from Family Health International. Preterm birth is a major cause of newborn death and illness, and by using tocolysis, preterm labor may be stalled long enough to allow corticosteroids to be administered to the fetus. This helps the fetus' lungs develop and improves his of her chances of survival after premature delivery.

Researchers reviewed 23 trials of more than 2,000 women and found that magnesium sulfate tocolysis was ineffective and may be harmful not only to infants but also to pregnant women. Some evidence suggests that magnesium sulfate may be associated with 1,900 to 4,800 fetal and neonatal deaths each year in the United States, and potentially life-threatening maternal complications of magnesium sulfate include respiratory arrest and pulmonary edema.

According to the researchers, alternative tocolysis therapies, especially the use of calcium channel blockers, are preferable to magnesium sulfate. Calcium channel blockers have been shown to reduce the rate of premature births before 34 weeks of gestation, have fewer maternal side effects than magnesium sulfate, and confer more benefits to infants.

Evidence Calls for Halt to Common Therapy to Delay Premature Labor [news release]. Research Triangle Park, NC: Family Health International; September 29, 2006.

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