P92. When there is a lack of magnesium during pregnancy

Abstract

Introduction The most frequent use of magnesium in cardiology is the adjuvant treatment of arterial hypertension, supraventricular and ventricular premature beats and in the heart failure. During pregnancy is even in the physiological statement higher magnesium consumption. In the therapeutic approaches in cardiovasular diseases in pregnancy is extremely important the influence of the mother's and child's hemodynamics. Furthermore is also relevant the placental transfer of the medication. The most frequent usage of magnesium during pregnancy from cardiologist's indications is arterial hypertension of the mother. In the prenatal period the conductive heart system is very sensitive to the ione imbalance. The most frequent manifestations are fetal premature supraventricular beats Objectives The aim of the study was to analyse the efficacy of the treatment of arterial hypertension during pregnancy and premature fetal atrial contractions. Methods The retrospective analysis of the pregnant females during the period 1 year. 1 We examined 4 patients in the age 32-38 years (median 34,6). In the 22th-28th gestational week (GW) (median 27,1) the new diagnosis of the arterial hypertension was confirmed. 2. We analysed 14 pregnant patients with the diagnosis of fetal arrhythmia. Mother‘s age at the time of diagnosis was 22-38 years (median 31,5). The fetal arrhythmia was detected at the 20th-38th GW (median 26,5). Patients were examined by ECHO and prenatal ECHO. Results 1. Analysis of the arterial hypertension during pregnancy: the average blood pressure (BP) at the entrance to the study was 146.7±5.8mmHg, heart rate (HR) 96.3±5.8/min. Patients were treated with the maximum tolerated dose of magnesium with the BP reduction to 112.4±5.8mmHg ( p p =0.05). In 1 patient (twins) was the magnesium treatment insufficient. The treatment with alphametyldopa was initiated. All patients tolerated the treatment with magnesium very good. In all patients was the reduction of the blood pressure after the delivery. Without further treatment of arterial hypertension. 2. Analysis of the fetal arrhythmias: In 10 patients (71.4%) was arrhythmia detected in the 20th–30th GW, in 1 patient (7.1%) in the 31st–35th GW and in 3 patients (21.4%) in the 36th–38th GW. In all patients were very frequent premature supraventricular beats – majority were isolated, in 2 patients was bigeminy present, in 1 patient trigeminy was present. The maximum tolerated dosage of magnesium was started. In 11 patients (78.6%) was reduction of the premature beats during the period less than 4 weeks. In 3 patients (detected in 36th–38th week) was the maintenance of the arrhythmia until the end of the pregnancy. After the delivery were presented only isolated premature beats with the spontaneous termination within 1 month after delivery. Conclusion In the case of adequate magnesium substitution is the new diagnosis of arterial hypertension and premature fetal supraventricular beats reversible in both: in the mother and fetus as well. However after the magnesium substitution is the disease non sustained even after the delivery. So it is very important to substitute magnesium during pregnancy. The adequate magnesium substitution during pregnancy could lead to the reduction of the stress for the mother and baby.