Про4етете ето тук (извадките са от реномирани специализирани списания):http://www.obgmanagement.com/article_pages.asp?AID=4667&UID=#bib2
В резюме от http://www.jfponline.com/Pages.asp?AID=4667
(Януари 2007):The long story of magnesium tocolysis
In the 1950s and 1960s, magnesium sulfate was not widely used as a tocolytic agent. In his single-author 1962 work, A Textbook of Obstetrics, Duncan E. Reid, MD, does not mention magnesium as a tocolytic agent. Magnesium is discussed in the book as an effective agent for seizure prophylaxis and treatment in women with preeclampsia/eclampsia. In the 1985 (17th) edition of Williams Obstetrics, the authors were not enthusiastic about the use of magnesium tocolysis and cited a small trial that concluded that magnesium tocolysis was not superior to placebo.
In the 1970s and 1980s, betamimetics were the most widely used tocolytic. One betamimetic, ritodrine, achieved FDA approval as a tocolytic agent, but is no longer manufactured.
Many clinical trials reported that betamimetics significantly decreased the number of women with preterm labor delivering within 48 hours of initiation of treatment. However, both concern over the many troublesome adverse effects of betamimetics and the marginal efficacy of these agents guided obstetricians to begin using magnesium because it appeared to have fewer adverse effects.
Obstetricians were familiar with magnesium because of its marked efficacy in preventing eclamptic seizures. In vitro studies demonstrated that magnesium inhibited myometrial contractility by competing with calcium at the plasma membrane channels and by interfering with calcium activation of myosin light-chain kinase. In addition, there was the theoretical supposition that magnesium might be neuroprotective for the newborn (later proved incorrect). Given obstetricians’ familiarity with magnesium for preeclampsia, it is easy to see how we embraced this treatment for preterm labor.Safety, efficacy are questionableData from trials never clearly demonstrated that magnesium has a clinically significant tocolytic effect compared with “control” treatments. In a Cochrane review of magnesium tocolysis, neither improvement in the risk of delivery before 48 hours nor reduction in risk of birth before 34 or 37 weeks was observed, compared with control treatments. More recent data also suggest that magnesium may increase the risk of adverse neonatal outcomes, including death, especially at the upper end of the magnesium dose rangeIn the absence of demonstrated clinical efficacy and a concern over potentially negative neonatal effects, obstetricians should consider strictly limiting their use of magnesium for tocolysis.
Crowther CA, Hiller JE, Doyle LW. Magnesium sulfate for preventing preterm birth in threatened preterm labour. Cochrane Database Syst Rev
Grimes DA, Nanda K. Magnesium sulfate tocolysis. Time to quit. Obstet Gynecol. 2006;108:986–989
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