الفهرس 
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Abstract
SUMMARY
Despite advances in obstetrics and neonatal care, the rate of incidence of preterm births continues to increase. Use of tocolytic agents such as magnesium sulfate could help in arresting preterm labor.
Magnesium sulfate (MgSO4) can be prescribed to pregnant women for different indications and, therefore, different physio pathologic roles, such as neuroprotection of the fetal brain, prevention of eclampsia, or tocolysis
The current study was designed to evaluate the fetal doppler changes and to detect fetal and maternal outcome in 100 cases received magnesium sulphate as a tocolytic agent in cases of pre-term delivery.
This was an interventional single arm clinical trial. Pregnant women with single fetus younger than 37 week’s gestational age if birth were planned or expected within 24 hours were included in the current study, while pregnant women presented in the second stage of labor, received magnesium sulfate therapy in this pregnancy or had contraindications to magnesium sulfate, were excluded from the current study.Full History taking, clinical examination and MgSO4 administration was done for all included women. Umbilical artery and middle cerebral artery Doppler were performed for all included women before and after MgSo4 administration.
The results of the current study revealed that, there was non-statistically significant change in the hemoglobin level as an effect of magnesium sulphate as a tocolytic agent in cases of pre-term delivery. MCA-PI was significantly increased after administration of MgSo4 (1.18 ±0.32 vs. 1.45 ±0.36, p<0.001), MCA-RI was significantly increased after administration of MgSo4 (0.65 ±0.10 vs. 0.77 ±0.15, p<0.001). UA-PI was significantly increased after administration of MgSo4 (0.76 ±0.20 vs. 0.94 ±0.27, p<0.001), UA-RI was mild increased after administration of MgSo4 (0.51 ±0.10 vs. 0.61 ±0.14, p<0.001)less than (0.7) . Only ten cases needed use of other tocolytics in form of Indomethacin &Nifedipine . Ten cases have post MgSo4 complications.
Complications were vomiting in four cases, diarrhea in eight cases and mild decreased blood pressure in four cases. Regarding neonatal outcomes, forty-eight cases were admitted to NICU (48%). Half the studied neonates showed associated morbidities in form of RDS (48 cases), sepsis and septic shock (16 cases), and jaundice (16 cases). Among the studied cases, 14 neonates died (14%), neonatal mortality occurred after duration ranged from 4 days to 4 weeks with an average duration of (2.35 ±1.1) weeks.
Based on the results of the current study we concluded that there was an overall improvement in fetal Doppler parameters after administration of magnesium sulfate as an effective tocolytic for preterm labor. The maternal side effects profile was few with the use of magnesium sulfate, this suggests that magnesium sulfate could be used as a safer effective alternative to ritodrine and nifedipine therapy.
Fetal Doppler study found a clinically significant effect on the pulsatility index (PI) of umbilical and middle cerebral artery with magnesium sulfate therapy, these findings ensure safety of the drugs on the maternal and fetal aspects.