MgSO4 for Neuroprotection in Preterm Birth

• MgSO4 is recommended for neuroprotection of the fetus in women at risk of early preterm birth.
• It should be considered for pregnancies below 32-34 weeks.
• MgSO4 should be administered regardless of the cause for preterm birth and number of babies.
• It should be given when early preterm birth is planned or expected within 24 hours.
• Administer as close as possible to 4 hours before birth if birth is planned.
• If delivery is expected sooner than 4 hours, MgSO4 should still be administered.
• Optimal regimen is an IV loading dose of 4g followed by 1g per hour maintenance.
• Treatment should continue until birth but stop after 24 hours if undelivered.
• Women should be monitored for magnesium toxicity every 4 hours.
• Monitoring should include pulse, blood pressure, respiratory rate, and deep tendon reflexes.

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