Magnesium Sulfate Treatment Research Articles

DSOG Guideline Bulletin: Preeclampsia and hypertension

Abstract Approximately 10% of pregnancies are complicated by hypertensive disorders of pregnancy (HDPs) in Denmark. The ‘Preeclampsia and hypertension’ guideline includes the classification, diagnosis, surveillance, and management of HDPs. This revision focuses on the diagnostic criteria for preeclampsia, preeclampsia-specific biomarkers for short-term prediction of disease, blood pressure thresholds and targets, and postpartum management. We reviewed the available literature in PubMed published since the last guideline revision in 2018, as well as the guidelines of other obstetric societies. HDPs are classified based on the timing of onset, i.e. before or after 20 weeks’ gestation, and whether proteinuria or other signs of organ dysfunction are present. We recommend against using the terms mild-moderate or severe preeclampsia in clinical practice. If possible, new-onset hypertension should be confirmed by home blood pressure monitoring. Women with HDPs should be monitored regularly, depending on diagnosis and clinical presentation. If blood pressure is ≥140 mmHg systolic and/or ≥90 mmHg diastolic, antihypertensive treatment with oral labetalol, nifedipine or methyldopa should be offered and titrated until reaching a target blood pressure of <135/85 mmHg. Magnesium sulphate treatment is recommended in eclampsia or signs of impending eclampsia. Delivery should be offered to women with preeclampsia no later than 37-38 weeks’ gestation; delivery is indicated sooner, regardless of gestational age, in preeclampsia with signs of serious, progressive disease which may include uncontrollable blood pressure, eclampsia, pulmonary oedema, progressive deterioration of biochemical parameters, or severe foetal compromise. Before operative delivery, blood pressure should be stable below 150/100 mmHg. Women with chronic or gestational hypertension should be offered planned delivery at 38-40 weeks’ gestation. Antihypertensive treatment should be continued at least one week after delivery. Lifelong yearly blood pressure monitoring is recommended to all women with HDPs.

Prenatal Magnesium Sulfate and Functional Connectivity in Offspring at Term-Equivalent Age

Understanding the effect of antenatal magnesium sulfate (MgSO4) treatment on functional connectivity will help elucidate the mechanism by which it reduces the risk of cerebral palsy and death. To determine whether MgSO4 administered to women at risk of imminent preterm birth at a gestational age between 30 and 34 weeks is associated with increased functional connectivity and measures of functional segregation and integration in infants at term-equivalent age, possibly reflecting a protective mechanism of MgSO4. This cohort study was nested within a randomized placebo-controlled trial performed across 24 tertiary maternity hospitals. Participants included infants born to women at risk of imminent preterm birth at a gestational age between 30 and 34 weeks who participated in the MAGENTA (Magnesium Sulphate at 30 to 34 Weeks' Gestational Age) trial and underwent magnetic resonance imaging (MRI) at term-equivalent age. Ineligibility criteria included illness precluding MRI, congenital or genetic disorders likely to affect brain structure, and living more than 1 hour from the MRI center. One hundred and fourteen of 159 eligible infants were excluded due to incomplete or motion-corrupted MRI. Recruitment occurred between October 22, 2014, and October 25, 2017. Participants were followed up to 2 years of age. Analysis was performed from February 1, 2021, to February 27, 2024. Observers were blind to patient groupings during data collection and processing. Women received 4 g of MgSO4 or isotonic sodium chloride solution given intravenously over 30 minutes. Prior to data collection, it was hypothesized that infants who were exposed to MgSO4 would show enhanced functional connectivity compared with infants who were not exposed. A total of 45 infants were included in the analysis: 24 receiving MgSO4 treatment and 21 receiving placebo; 23 (51.1%) were female and 22 (48.9%) were male; and the median gestational age at scan was 40.0 (IQR, 39.1-41.1) weeks. Treatment with MgSO4 was associated with greater voxelwise functional connectivity in the temporal and occipital lobes and deep gray matter structures and with significantly greater clustering coefficients (Hedge g, 0.47 [95% CI, -0.13 to 1.07]), transitivity (Hedge g, 0.51 [95% CI, -0.10 to 1.11]), local efficiency (Hedge g, 0.40 [95% CI, -0.20 to 0.99]), and global efficiency (Hedge g, 0.31 [95% CI, -0.29 to 0.90]), representing enhanced functional segregation and integration. In this cohort study, infants exposed to MgSO4 had greater voxelwise functional connectivity and functional segregation, consistent with increased brain maturation. Enhanced functional connectivity is a possible mechanism by which MgSO4 protects against cerebral palsy and death.

Efficacy of Magnesium Sulfate and Labetalol in the Treatment of Pregnancy-Induced Hypertension and Its Effect on Anxiety and Depression: A Retrospective Cohort Study.

In this study, the effect of magnesium sulfate and labetalol in treating pregnancy-induced hypertension (PIH) and its influence on anxiety and depression in patients are observed, and new ideas for treating anxiety and depression in PIH are introduced. A retrospective cohort study was conducted to select patients with PlH diagnosed from July 2020 to July 2023 from Affiliated Hospital of Electronic Science and Technology University and Chengdu Women' s and Children's Central Hospital in Chengdu of Sichuan Province. The changes in blood pressure, Edinburgh Postnatal Depression Scale (EPDS), and generalized anxiety disorder 7 (GAD-7) in patients with hypertensive pregnancy were collected and analyzed. In our investigation, 219 patients completed the study, and 36.1% (79/219) of them developed anxiety and depression. According to whether the patients were treated with magnesium sulfate and labetalol, 49 cases were assigned to the magnesium sulfate and labetalol treatment (MSLT) group, and 30 cases were assigned to the conventional treatment (CT) group. Edinburgh Postnatal Depression Scale scores and GAD-7 scores in the MSLT group were significantly lower than those in the CT group, indicating that magnesium sulfate and labetalol can improve anxiety and depression in hypertensive patients during pregnancy. The difference was statistically significant (P < .05). According to the changes in systolic blood pressure, the clinical efficacy of patients was evaluated, and no significant difference in efficacy existed between the MSLT and CT groups. Magnesium sulfate and labetalol can control the blood pressure of patients with PIH and indirectly improve anxiety and depression in patients with PIH, thereby introducing new ideas for the treatment of PIH accompanied by anxiety and depression.

Enoxaparin sodium combined with magnesium sulfate in the treatment of severe preeclampsia.

To observe the treatment of severe preeclampsia in newborns with enoxaparin sodium combined with magnesium sulfate. A retrospective analysis was conducted on the clinical data of 80 patients with severe preeclampsia admitted to Hefei Second People's Hospital, China from January 2019 to December 2020. Treatment records showed that 40 cases received magnesium sulfate treatment (single group), and 40 cases received enoxaparin sodium combined with magnesium sulfate treatment (combination group). Levels of D-dimer, soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PLGF), Apgar scores of newborns delivered before and after treatment were compared. Gestation weeks and incidence of adverse reactions were analyzed. After treatment, levels of D-dimer, sfit-1 and adverse reactions in the combination group were significantly lower than those in the single group (P<0.05), and the level of PLGF, newborn Apgar score and length of gestation were significantly higher than those in the single group (P<0.05). Compared to magnesium sulfate alone, the combination of enoxaparin sodium and magnesium sulfate in the treatment of pregnant women with severe preeclampsia can more effectively regulate the cytokine level of patients, improve pregnancy outcome, and improve neonatal Apgar score. The incidence of adverse reactions is low, making it a safe and efficient treatment modality.

Validation of a Model for Predicting Magnesium Concentration in Women with Preeclampsia: A Retrospective Cohort Study.

To validate a model for predicting magnesium concentration in magnesium sulfate treatment in preeclampsia. Retrospective cohort study. Setting. Three secondary care hospitals, one accepting neonates from gestational week 28 + 0. Population. Women with preeclampsia undergoing magnesium sulfate treatment. Subjects initially received Zuspan treatment (4 g bolus and 1 g/h maintenance dose), commonly increased by individual titration. Main Outcome Measures. Difference in mean between measured and predicted magnesium concentration. Proportion of women reaching target concentration (>2 mM) in 25 h. 56 women were included, with 356 magnesium measurements available. Mean magnesium concentration was 1.82 mM. The prediction model overestimated magnesium concentration by 0.10 mM (CI 0.04-0.16) but exhibited no bias for weight, creatinine, or treatment duration. Weighted mean infusion rate was 1.22 g/h during 30 hours. Overall success rate in reaching target concentration was 54%, decreasing to 40% in women > 95 kg. Overall success rate at 8 hours was 11%. No toxic concentrations were found. Zuspan regimen is very safe, but slow to reach therapeutic concentrations-despite efforts of individual titration. Success rate is lower in heavy women, which is of particular importance considering their predisposition to develop preeclampsia. The validated pharmacokinetic model performs well and may be used to individually tailor treatment from the outset.

Effect of calcium and magnesium nutrition on vegetative growth and tuber yield of potato (Solanum tuberosum)

A field experiment was conducted to investigate the effect of calcium nitrate and magnesium sulfate on the growth and tuber yield in potato (Solanum tuberosum L). Experiment was carried out in split-plot design comprising of nine calcium nitrate and magnesium sulfate treatments i.e.T1- Ca(NO3)2 @ 0.5%, T2- Ca(NO3)2 @ 1%, T3- Ca(NO3)2 @ 2%, T4- MgSO4 @ 0.5%, T5- MgSO4 @ 1%, T6- MgSO4 @ 2%, T7- Ca(NO3)2 @ 1% + MgSO4 @ 1%, T8- Ca(NO3)2 @ 2% + MgSO4 @ 2%, T9- Control on two potato varieties i.e. Kufri Jyoti and Kufri Chandramukhi. Data collected on different parameters were analyzed using CPCS1 software. Among all the calcium nitrate and magnesium sulfate treatments, application of Ca(NO3)2 @ 2% + MgSO4 @ 2% was found to be the best for most of the parameters studied and between the varieties Kufri Jyoti was found highly significant for the different parameters under study. Hence it can be concluded that commercial cultivation of potato in the central region of Punjab can be successfully supplemented with application of Ca (NO3)2 + MgSO4 and variety Kufri Jyoti.

Preterm Birth: A Review of Its Early Diagnosis and Prevention

Preterm birth, a major global healthcare concern, is characterized by infants being born before completing 37 weeks of gestation. Accurate diagnosis and effective interventions are critical to managing this complex issue. This abstract provides an overview of the diagnosis and prevention of preterm birth, focusing on risk assessment, diagnostic techniques, and various interventions for mothers and newborns. The diagnostic process involves evaluating risk factors, clinical history, and the assessment of potential membrane rupture. Techniques such as speculum examination, the Nitrazine test, the Fern test, ultrasonography, and the Placental Alpha Microglobulin-1 test play vital roles in identifying membrane rupture and infection. Additional diagnostic markers include cervical ultrasonography and fetal fibronectin testing. Prevention strategies include lifestyle changes, maternal therapies, and antenatal interventions. Smoking cessation programs, low-dose aspirin, antenatal corticosteroid therapy, progesterone supplementation, magnesium sulfate, and antibiotic treatment are employed to reduce the risk of preterm birth. Cervical cerclage, another surgical intervention, is recommended in specific cases.&#x0D; For preterm newborns, immediate and effective care is vital. This includes thermal care, early breastfeeding, infection prevention, and respiratory distress syndrome management. These interventions are crucial in reducing infant mortality and morbidity associated with preterm birth. Efforts to diagnose and prevent preterm birth are essential in improving the well-being of both mothers and their newborns. A comprehensive approach, combining accurate diagnosis and effective interventions, can make a significant impact in reducing the burden of preterm birth on healthcare systems and families.&#x0D; Keywords: Preterm birth, infants, gestation, potential membrane rupture

Therapeutic potential of Omega-3 polyunsaturated fatty acids on the immune function of patients with hypertensive disorder complicating pregnancy and preeclampsia.

This paper aims to explore the mechanism of Omega-3 polyunsaturated fatty acids (PUFA) on the immune function of patients having pregnancy induced hypertension (PIH). Through a retrospective study, 168 patients with PIH syndrome who were cured at the First Affiliated Hospital of Hebei North University (January 2020 to December 2021) were randomly divided into the Omega-3 treated group and the control group, with 84 cases in each group. The control group received treatment with magnesium sulfate. The other group was treated with PUFAs based on the magnesium sulfate treatment. To evaluate the differences in diastolic pressure, systolic pressure and inflammatory factors between the Omega-3 treated group and control group, statistical analysis was conducted using SPSS 23.0 software. The measurement data were subject to t-test, and x 2 test was adopted for counting data. The treatment efficiency of the Omega-3 treated group and the control group was 95.24% and 80.95%, respectively, with a significant difference (P<0.05). Before receiving treatment, there was no difference in diastolic and systolic pressure, various inflammatory factors and various immune functions between these two groups (P>0.05). The group treated with omega-3 had lower CD3+, CD4+ and the CD4+/CD8+ ratio than the control group (P<0,05). The Omega-3 treated group had significantly higher IL-4 and CD8+ than those in the control group (P<0.05). Intravenous injection of Omega-3 can reduce blood pressure, improve immune function, and reduce inflammatory reactions in patients with gestational hypertension.

Bridging Models: Preeclampsia Biomarkers in Salt-Loaded Rats and Human Patients

Preeclampsia, a pregnancy-specific syndrome with multisystem involvement, significantly contributes to maternal and fetal morbidity and mortality. This study compared physiological, fetal, and placental parameters between preeclamptic women and salt-loaded pregnant rats, an established animal model for preeclampsia. We evaluated lipid peroxidation levels in both placental homogenates and red blood cell ghosts, and Ca-ATPase activity in placental homogenates. Additionally, we assessed the effects of magnesium sulfate (MgSO4) treatment on these parameters. Salt-loaded pregnant rats received 1.8% NaCl solution ad libitum for seven days starting from the 15th day of pregnancy. For analysis, blood and placental samples were obtained from preeclamptic women and the rat model. Results showed that salt-loaded pregnant rats exhibited similar characteristics to preeclamptic women, including increased lipid peroxidation, and lowered Ca-ATPase activity in placental and red blood cell ghosts. MgSO4 treatment in preeclamptic women and salt-loaded rats modified Ca-ATPase activity and lipid peroxidation levels in red blood cell membranes and placental membranes, bringing values closer to normal values. The reduction in lipid peroxidation by MgSO4 may account for increased Ca-ATPase activity. This study validates the salt-loaded pregnant rat model as a valuable tool for investigating preeclampsia, offering insights into the condition's pathophysiology and potential therapeutic interventions.

Antenatal neuroprotective magnesium sulfate in very preterm infants and its association with feeding intolerance.

Magnesium sulfate (MgSO4) treatment is widely used for fetal neuroprotection despite the controversy concerning the side effects. There is limited data regarding the impact of various cumulative maternal doses and neonatal serum magnesium (Mg) levels on short-term neonatal morbidity and mortality. We opted to carry out a study to determine the impact of neonatal serum Mg levels on neonatal outcomes. We conducted this prospective observational study between 2017 and 2021. Antenatal MgSO4 was used for a neuroprotective purpose only during the study period. Inborn preterm infants delivered between 23 and 31 6/7 weeks of gestation were enrolled consecutively. Babies who underwent advanced resuscitation in the delivery room, inotropic treatment due to hemodynamic instability in the first 7 days of life, >12 hours since the discontinuation of maternal MgSO4 treatment, severe anemia, and major congenital/chromosomal anomalies were excluded from the study. The subgroup of babies with serum Mg level at the sixth hour of life underwent an analysis. A neonatal Mg concentration of 2.5mg/dl was used to classify MgSO4-exposed patients into two groups (<2.5 mg/dl and ≥2.5 mg/dl). Another analysis was performed between babies whose mothers were exposed to MgSO4 and those not exposed. Finally, the groups' neonatal outcomes were compared. Of the 584 babies, 310 received antenatal MgSO4. The birth weights were significantly lower in the MgSO4 exposed group (1113 ± 361g vs. 1202 ± 388g, p=0.005). Antenatal corticosteroid usage and intrauterine growth restriction were also noted to be higher. The MgSO4 group was more likely to have bronchopulmonary dysplasia, prolonged invasive ventilation, necrotizing enterocolitis, delayed enteral nutrition, and feeding intolerance (p<0.05). MgSO4 treatment was shown as an independent risk factor for feeding intolerance when corrected for confounders (OR 2.13 95% CI 1.4-3.1, p=0.001). Furthermore, serum Mg level significantly correlated with feeding intolerance (r =0.21, p=0.002). This study highlighted the effect of MgSO4 treatment and the potential superiority of serum the Mg level as a predictor of immediate neonatal outcomes, particularly delayed enteral nutrition and feeding intolerance. Further studies are warranted to ascertain the optimal serum Mg concentration of preterm infants in early life to provide maximum benefit with minimal side effects.

Does MgSO4 Treatment Affect Maternal Aspartate Aminotransferase to Platelet Ratio Index (APRI) Score in Preterm Labor?

Aim: This study evaluated the association between magnesium sulfate treatment for fetal neuroprotection on APRI scores in pregnant women with the preterm birth threat.&#x0D; Material and Methods: Thirty-one pregnant women hospitalized and received MgSO4 for preterm birth risk in the Obstetrics and Gynecology Department, between 2019-2022 were included, and the patient records were evaluated retrospectively. The fetal neuroprotective MgSO4 treatment protocol included administering a loading infusion dose of 4 grams/30 minutes followed by a 1 gram/hour infusion for 24 hours to pregnant women hospitalized for a threat of preterm labor. In addition, the electrocardiography, hemogram, and hepatic and renal functions were evaluated upon hospitalization before MgSO4 administration, and patients were monitored closely. Women who gave birth before completion of 24 hours of MgSO4 administration, multiple pregnancies, patients with comorbid deteriorated liver or kidney functions, preeclampsia, intrauterine growth retardation, fetal abnormalities, gestational diabetes mellitus, chorioamnionitis, adolescent and advanced age pregnancies or any other obstetric complications were excluded from analyses. The APRI score was calculated and compared between the results of the biochemical analyses performed at initiation (basal) and 12th hour of MgSO4 administration.&#x0D; Results: The mean APRI score at the 12th hour of administration (0.45±0.07) was significantly higher than the basal values (0.31±0.07) (p0.05 for all).&#x0D; Conclusions: Magnesium sulfate treatment for preterm birth threat significantly increases APRI score at the 12th hour of administration.

Long-term effects of prenatal magnesium sulfate exposure on nervous system development in preterm-born children.

This study used structural magnetic resonance imaging to analyze changes in the gray matter volume (GMV) of preterm-born (PTB) and term-born (TB) children to help elucidate the influence of magnesium sulfate treatment on the nervous system development. A total of 51 subjects were recruited, including 28 PTB and 23 TB children. The intelligence scale and MRI scan were completed at the corrected age of 10 to 16 years. A whole-brain voxel-wise analysis tested the main effect of the status (PTB without magnesium, PTB with magnesium, and TB) using a factorial design in SPM8. The mean volumes of the regions that showed significant group effects on the GMV after the FDR correction were extracted in the common space for each subject. Verbal and full-scale intelligence quotient scores were significantly lower for PTB children without magnesium than for TB children; however, the scores of PTB children with magnesium and TB children were almost identical. Compared with TB children, PTB children had significantly reduced left straight gyrus and left inferior frontal gyrus GMVs; however, the volumes of PTB children with magnesium were closer to those of TB children. Changes in the GMV of the left inferior frontal gyrus were significantly correlated with full-scale and verbal intelligence quotient scores, whereas the lower gestational age at the time of mgsou4 treatment led to a larger GMV of the left inferior frontal gyrus. Brain structural abnormalities could exist in PTB children. The GMVs of the left straight gyrus and left inferior frontal gyrus were significantly reduced in these children. The influence of magnesium sulfate treatment was not significant, but the cognitive levels of these children were significantly increased and almost identical to those of TB children. Initiation of magnesium sulfate treatment during gestation is negatively correlated with the left inferior frontal gyrus GMV.

Magnesium sulfate treatment for acute severe asthma in adults-a systematic review and meta-analysis.

Add-on magnesium sulfate (MgSO4) for refractory asthma exacerbation has been much debated. The aim of this review and meta-analysis is, therefore, to provide an update on the current evidence for the efficacy of MgSO4 in exacerbations of asthma in adults refractory to standard of care treatment. A systematic review was performed in accordance with the PRISMA guidelines. The search was performed in the PubMed database (updated April 2023). For the meta-analysis, a random-effects model was applied using the metaphor package for RStudio (RStudio, Inc.). A total of 17 randomized controlled trials were included. Three of the nine studies addressing treatment with intravenous (IV) MgSO4 found a significant effect on lung function compared to placebo. Of the eight studies investigating hospital admission rate, only two found a significant effect of MgSO4. Six of the nine studies investigating treatment with nebulized MgSO4 compared to placebo found a favorable effect on forced expiratory volume in 1. second (FEV1) and peak expiratory flow rate (PEF). Only two of the five studies investigating the effect on hospital admission rate found an effect of MgSO4. Comparing effect sizes in a meta-analysis revealed a greater effect on PEF in asthma patients treated with nebulized MgSO4 (MD, 23.57; 95% CI, -2.48 to 49.62, p < 0.01) compared to placebo. The analysis of patients treated with i.v. MgSO4 compared to placebo showed no statistically significant difference (MD, 5.49; 95% CI, -18.67 to 29.65, p = 0.10). Up to two out of three studies revealed an effect of MgSO4 treatment for asthma exacerbation when assessed by FEV1/PEF, but fewer studies were positive for the outcome of hospital admissions.

Analysis of the Influence of Nifedipine + Magnesium Sulfate Therapy on the Clinical Effect of Pregnancy-Induced Hypertension, Renal Function, and Pregnancy Outcome

Objective: To investigate the effect of nifedipine + magnesium sulfate treatment on pregnancy-induced hypertension. Methods: From January 2020 to January 2023, 60 patients with pregnancy-induced hypertension in our hospital were randomly divided into the control group and the observation group (30 cases in each group). The control group was treated with magnesium sulfate, while the observation group was treated with nifedipine and magnesium sulfate, and the clinical efficacy of the two groups was compared. The effective rate of treatment, blood pressure indicators, renal function indicators, adverse pregnancy outcomes, and quality-of-life scores were investigated. Results: The effective rate of treatment and quality-of-life score in the observation group were higher than those in the control group (P &lt; 0.05). On the other hand, the diastolic and systolic blood pressure, the 24 h urine creatinine and albumin, as well as the adverse pregnancy outcomes were found to be lower in the observation group as compared to the control group (P &lt; 0.05). Conclusion: For patients with pregnancy-induced hypertension, treatment with nifedipine and magnesium sulfate can achieve significant curative and remarkable effects. While improving blood pressure, it can also improve renal function, optimize pregnancy outcomes, and improve quality of life.

Hyphal Growth in Trichosporon asahii Is Accelerated by the Addition of Magnesium.

Fungal dimorphism involves two morphologies: a unicellular yeast cell and a multicellular hyphal form. Invasion of hyphae into human cells causes severe opportunistic infections. The transition between yeast and hyphal forms is associated with the virulence of fungi; however, the mechanism is poorly understood. Therefore, we aimed to identify factors that induce hyphal growth of Trichosporon asahii, a dimorphic basidiomycete that causes trichosporonosis. T. asahii showed poor growth and formed small cells containing large lipid droplets and fragmented mitochondria when cultivated for 16 h in a nutrient-deficient liquid medium. However, these phenotypes were suppressed via the addition of yeast nitrogen base. When T. asahii cells were cultivated in the presence of different compounds present in the yeast nitrogen base, we found that magnesium sulfate was a key factor for inducing cell elongation, and its addition dramatically restored hyphal growth in T. asahii. In T. asahii hyphae, vacuoles were enlarged, the size of lipid droplets was decreased, and mitochondria were distributed throughout the cell cytoplasm and adjacent to the cell walls. Additionally, hyphal growth was disrupted due to treatment with an actin inhibitor. The actin inhibitor latrunculin A disrupted the mitochondrial distribution even in hyphal cells. Furthermore, magnesium sulfate treatment accelerated hyphal growth in T. asahii for 72 h when the cells were cultivated in a nutrient-deficient liquid medium. Collectively, our results suggest that an increase in magnesium levels triggers the transition from the yeast to hyphal form in T. asahii. These findings will support studies on the pathogenesis of fungi and aid in developing treatments. IMPORTANCE Understanding the mechanism underlying fungal dimorphism is crucial to discern its invasion into human cells. Invasion is caused by the hyphal form rather than the yeast form; therefore, it is important to understand the mechanism of transition from the yeast to hyphal form. To study the transition mechanism, we utilized Trichosporon asahii, a dimorphic basidiomycete that causes severe trichosporonosis since there are fewer studies on T. asahii than on ascomycetes. This study suggests that an increase in Mg2+, the most abundant mineral in living cells, triggers growth of filamentous hyphae and increases the distribution of mitochondria throughout the cell cytoplasm and adjacent to the cell walls in T. asahii. Understanding the mechanism of hyphal growth triggered by Mg2+ increase will provide a model system to explore fungal pathogenicity in the future.

Effect of magnesium sulfate treatment on mediators of endothelial dysfunction and electrolytes in mild and severe preeclampsia: A case-control study.

Magnesium sulfate (MgSO4) treatment is widely used for the prevention of eclamptic seizures. However, its effect on mediators of endothelial dysfunction (ED) and electrolytes remains unclear. We evaluated the effects of MgSO4 treatment on mediators of ED and electrolytes. We recruited 100 women comprising 50 severe, 50 mild preeclampsia (PE) as cases and 50 normotensive pregnant women as controls from the Sampa Government Hospital, Ghana. We estimated for adrenomedullin (AM),calcitonin gene-related peptide (CGRP),soluble forms of intercellular adhesion molecule-1 (sICAM-1), Na+, K+, and Mg2+ before MgSO4 treatment, 24 h after MgSO4 treatment, and 48 h after delivery. p < 0.05 were considered significant for statistical analyses. Levels of AM, sICAM-1, and Na+ decreased significantly at 24 h after MgSO4 treatment and 48 h after delivery among PEwomen compared to the AM levels before treatment (p < 0.0001). The levels of CGRP and Mg2+ increased significantly after 24 h of MgSO4 treatment and 48 h after delivery among PE compared to the AM levels before treatment (p < 0.0001). The changes in AM, sICAM-1, CGRP, and Mg2+ at 24 h after treatment and 48 h after delivery were significantly higher in severe compared to mild PE (p < 0.0001). AM levels reduced significantly by 14.7% in mild and 42.7% in severe PE after MgSO₄ treatment (p < 0.05). sICAM-1 levels reduced significantly by 20.9% in mild and 25% in severe PE after MgSO₄ treatment. After MgSO₄ treatment, there was significant increase of 42.1% and >100% in CGRP levels in mild and severe PE, respectively (p < 0.05). After MgSO₄ treatment, Mg²⁺ levels increased significantly by 67.0% and 63.8% in mild and severe PE, respectively (p < 0.05). MgSO₄ treatment reduces AM, sICAM-1, and sodium levels but improves magnesium and CGRP in severe than mild PE thus have more beneficial role in severe PE.

Magnesium sulphate reduces tertiary gliosis but does not improve EEG recovery or white or grey matter cell survival after asphyxia in preterm fetal sheep.

Maternal magnesium sulphate (MgSO4 ) treatment is widely recommended before preterm birth for neuroprotection. However, this is controversial because there is limited evidence that MgSO4 provides long-term neuroprotection. Preterm fetal sheep (104days gestation; term is 147days) were assigned randomly to receive sham occlusion with saline infusion (n=6) or i.v. infusion with MgSO4 (n=7) or vehicle (saline, n=6) from 24h before hypoxia-ischaemia induced by umbilical cord occlusion until 24h after occlusion. Sheep were killed after 21days of recovery, for fetal brain histology. Functionally, MgSO4 did not improve long-term EEG recovery. Histologically, in the premotor cortex and striatum, MgSO4 infusion attenuated post-occlusion astrocytosis (GFAP+ ) and microgliosis but did not affect numbers of amoeboid microglia or improve neuronal survival. In the periventricular and intragyral white matter, MgSO4 was associated with fewer total (Olig-2+ ) oligodendrocytes compared with vehicle+occlusion. Numbers of mature (CC1+ ) oligodendrocytes were reduced to a similar extent in both occlusion groups compared with sham occlusion. In contrast, MgSO4 was associated with an intermediate improvement in myelin density in the intragyral and periventricular white matter tracts. In conclusion, a clinically comparable dose of MgSO4 was associated with moderate improvements in white and grey matter gliosis and myelin density but did not improve EEG maturation or neuronal or oligodendrocyte survival. KEY POINTS: Magnesium sulphate is widely recommended before preterm birth for neuroprotection; however, there is limited evidence that magnesium sulphate provides long-term neuroprotection. In preterm fetal sheep exposed to hypoxia-ischaemia (HI), MgSO4 was associated with attenuated astrocytosis and microgliosis in the premotor cortex and striatum but did not improve neuronal survival after recovery to term-equivalent age, 21days after HI. Magnesium sulphate was associated with loss of total oligodendrocytes in the periventricular and intragyral white matter tracts, whereas mature, myelinating oligodendrocytes were reduced to a similar extent in both occlusion groups. In the same regions, MgSO4 was associated with an intermediate improvement in myelin density. Functionally, MgSO4 did not improve long-term recovery of EEG power, frequency or sleep stage cycling. A clinically comparable dose of MgSO4 was associated with moderate improvements in white and grey matter gliosis and myelin density but did not improve EEG maturation or neuronal or oligodendrocyte survival.

Term Neonatal Outcomes after Maternal Magnesium Sulfate Treatment for Seizure Prophylaxis.

This study aimed to evaluate term neonatal outcomes after maternal magnesium sulfate (MgSO4) treatment for seizure prophylaxis. This was a single-site retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes from January 2013 through December 2020. Our primary outcome was neonatal intensive care unit (NICU) admission. We compared outcomes between women treated with MgSO4 for 24 hours or more and women treated with MgSO4 for less than 24 hours prior to delivery. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval (95% CI), controlling for variables with a p < 0.05 based on bivariable analysis. Of 834 women analyzed, 173 (20.7%) neonates were admitted to the NICU. Women treated with MgSO4 for 24 hours or more compared with women treated with MgSO4 for less than 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (27.3 vs. 18.9%; p = 0.01), neonates requiring immediate NICU admission (24.6 vs. 18.3%; p < 0.01), and NICU admission for neonatal lethargy. After adjusting for covariates, only NICU admission due to neonatal lethargy remained statistically significant (aOR: 4.78 [95% CI: 1.50-15.21]). Prolonged MgSO4 treatment for 24 hours or more was associated with increased odds of term NICU admission due to neonatal lethargy. · NICU admission rose with longer magnesium treatment.. · Nulliparous patients had more magnesium sulfate exposure.. · Obese patients had longer magnesium sulfate exposure..

Effect of Compound Danshen Injection Combined with Magnesium Sulfate on Oxidative Stress, TNF-α, NO, and Therapeutic Efficacy in Severe Preeclampsia.

Aims This study is designed to explore the effect of compound Danshen injection combined with magnesium sulfate on TNF-α, NO, oxidative stress, and therapeutic efficacy in severe preeclampsia (S-PE). Methods Sixty S-PE patients were placed into the control group and the therapy group, randomly. The control group was under the treatment of magnesium sulfate, and the therapy group was under the treatment of compound Danshen injection with magnesium sulfate. After treatment, the therapeutic efficacy of the two groups was comparatively analyzed. Results 7 days after treatment, DBP, SBP, and 24 h urinary protein were sharply lower than those before treatment. The 24 h urinary protein was notably lower in the therapy group. After treatment, the expression level of TNF-α in both groups was notably higher than before treatment, while NO level was higher than that before treatment. Furthermore, D-D level in two groups was dramatically decreased compared to that before treatment. Moreover, Fib, PT, and APTT in two groups showed statistically significant differences after 7 days. The contents of ALT, AST, BUN, and Scr in therapy group were notably lower than those in control group. Conclusion Our results indicated that compound Danshen injection could improve renal function, blood hypercoagulability, and oxidative stress level and had a better therapeutic effect on S-PE.

Nifedipine plus Systematic Nursing on Pregnancy Outcomes in Patients with Gestational Hypertension.

Objective To study the effect of nifedipine combined with systematic nursing on pregnancy outcomes in patients with gestational hypertension. Methods According to the random number table method, 120 patients with gestational hypertension treated in our hospital were divided into the control group (60 cases) and observation group (60 cases). The control group was given magnesium sulfate treatment, the observation group was given magnesium sulfate combined with nifedipine, and the two groups of patients were given systematic nursing. The blood pressure levels, negative emotions, and pregnancy outcomes of the two groups of patients before and after treatment were compared. The blood pressure levels of the two groups before and after treatment were measured by the electronic sphygmomanometer, and the self-rating depression scale (SDS) and self-rating scale (SAS) were used to evaluate the depression and anxiety of the two groups, respectively. Results After treatment, the systolic blood pressure, diastolic blood pressure, SDS score, and SAS score of the two groups were decreased, and the observation group was significantly lower than the control group. Additionally, the observation group had lower incidence of cesarean section, postpartum hemorrhage, premature rupture of membranes, and neonatal asphyxia (P < 0.05). Conclusion Nifedipine plus systematic nursing in patients with gestational hypertension can effectively improve the pregnancy outcome and adverse emotions such as depression and anxiety, reduce blood pressure, and promote disease recovery.