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Cerebral spinal fluid and serum ionized magnesium and calcium levels in preeclamptic women during administration of magnesium sulfate.
Fertil Steril 2010; 94(1):276-82FS

Abstract

OBJECTIVE

To study the distribution of ionized and total magnesium (Mg) in serum and cerebral spinal fluid (CSF) in preeclamptic women receiving MgSO(4) and how this treatment affects the ionized calcium (Ca(2+)) and ionized Ca:Mg ratios compared with healthy nonpregnant women and pregnant control women (HP).

DESIGN

Controlled clinical study.

SETTING

An academic medical center.

PATIENT(S)

African-American women older than 20 and less than 35 years. The pregnant preeclamptic study and pregnant control groups each consisted of 16 women; the nonpregnant group consisted of 10 subjects.

INTERVENTION(S)

The preeclamptic women received a 6-g bolus of MgSO(4) IV started at least 4.5 hours before delivery during 15-20 minutes, then 2 g/h baseline.

MAIN OUTCOME MEASURE(S)

The CSF and serum levels of Ca(2+) and Mg(2+) and total Mg were measured in all three groups of women. The Ca(2+):Mg(2+) ratios were determined. Physiologic monitoring was done and recorded every 4 hours where appropriate. Bloods were drawn every 6 hours for complete blood count, metabolic panel, lactate dehydrogenase, uric acid, and electrolytes. Serum pH, total Mg, Apgar scores, and general health of the infants born to preeclamptic mothers given MgSO(4) were followed.

RESULT(S)

The HP showed a reduction in mean serum ionized and total Mg, increase in ionized Ca, and a large increase in Ca(2+):Mg(2+) ratios compared with healthy nonpregnant women. Although the CSF ionized and total Mg and Ca(2+):Mg(2+) ratios were not altered with MgSO(4) treatment in the preeclamptic women receiving MgSO(4), the mean serum Mg values increased 3-fold. All infants were full-term, regardless of MgSO(4) treatment, and normal with respect to birth weight, Apgar scores, blood pH, total Mg, and neurologic scores.

CONCLUSION(S)

The data indicate that there is a direct relationship between the serum and CSF Ca(2+):Mg(2+) ratios in HP and this ratio may be crucial in preventing vascular and neurologic complications in preeclampsia-eclampsia.

Authors+Show Affiliations

Department of Anesthesiology, State University of New York, Downstate Medical Center, Brooklyn, New York 11203, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

19324346

Citation

Apostol, Alexander, et al. "Cerebral Spinal Fluid and Serum Ionized Magnesium and Calcium Levels in Preeclamptic Women During Administration of Magnesium Sulfate." Fertility and Sterility, vol. 94, no. 1, 2010, pp. 276-82.
Apostol A, Apostol R, Ali E, et al. Cerebral spinal fluid and serum ionized magnesium and calcium levels in preeclamptic women during administration of magnesium sulfate. Fertil Steril. 2010;94(1):276-82.
Apostol, A., Apostol, R., Ali, E., Choi, A., Ehsuni, N., Hu, B., ... Altura, B. M. (2010). Cerebral spinal fluid and serum ionized magnesium and calcium levels in preeclamptic women during administration of magnesium sulfate. Fertility and Sterility, 94(1), pp. 276-82. doi:10.1016/j.fertnstert.2009.02.024.
Apostol A, et al. Cerebral Spinal Fluid and Serum Ionized Magnesium and Calcium Levels in Preeclamptic Women During Administration of Magnesium Sulfate. Fertil Steril. 2010;94(1):276-82. PubMed PMID: 19324346.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cerebral spinal fluid and serum ionized magnesium and calcium levels in preeclamptic women during administration of magnesium sulfate. AU - Apostol,Alexander, AU - Apostol,Radu, AU - Ali,Erum, AU - Choi,Anne, AU - Ehsuni,Nazanin, AU - Hu,Bin, AU - Li,Lei, AU - Altura,Bella T, AU - Altura,Burton M, Y1 - 2009/03/26/ PY - 2008/12/09/received PY - 2009/02/05/revised PY - 2009/02/06/accepted PY - 2009/3/28/entrez PY - 2009/3/28/pubmed PY - 2010/6/18/medline SP - 276 EP - 82 JF - Fertility and sterility JO - Fertil. Steril. VL - 94 IS - 1 N2 - OBJECTIVE: To study the distribution of ionized and total magnesium (Mg) in serum and cerebral spinal fluid (CSF) in preeclamptic women receiving MgSO(4) and how this treatment affects the ionized calcium (Ca(2+)) and ionized Ca:Mg ratios compared with healthy nonpregnant women and pregnant control women (HP). DESIGN: Controlled clinical study. SETTING: An academic medical center. PATIENT(S): African-American women older than 20 and less than 35 years. The pregnant preeclamptic study and pregnant control groups each consisted of 16 women; the nonpregnant group consisted of 10 subjects. INTERVENTION(S): The preeclamptic women received a 6-g bolus of MgSO(4) IV started at least 4.5 hours before delivery during 15-20 minutes, then 2 g/h baseline. MAIN OUTCOME MEASURE(S): The CSF and serum levels of Ca(2+) and Mg(2+) and total Mg were measured in all three groups of women. The Ca(2+):Mg(2+) ratios were determined. Physiologic monitoring was done and recorded every 4 hours where appropriate. Bloods were drawn every 6 hours for complete blood count, metabolic panel, lactate dehydrogenase, uric acid, and electrolytes. Serum pH, total Mg, Apgar scores, and general health of the infants born to preeclamptic mothers given MgSO(4) were followed. RESULT(S): The HP showed a reduction in mean serum ionized and total Mg, increase in ionized Ca, and a large increase in Ca(2+):Mg(2+) ratios compared with healthy nonpregnant women. Although the CSF ionized and total Mg and Ca(2+):Mg(2+) ratios were not altered with MgSO(4) treatment in the preeclamptic women receiving MgSO(4), the mean serum Mg values increased 3-fold. All infants were full-term, regardless of MgSO(4) treatment, and normal with respect to birth weight, Apgar scores, blood pH, total Mg, and neurologic scores. CONCLUSION(S): The data indicate that there is a direct relationship between the serum and CSF Ca(2+):Mg(2+) ratios in HP and this ratio may be crucial in preventing vascular and neurologic complications in preeclampsia-eclampsia. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/19324346/Cerebral_spinal_fluid_and_serum_ionized_magnesium_and_calcium_levels_in_preeclamptic_women_during_administration_of_magnesium_sulfate_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(09)00373-2 DB - PRIME DP - Unbound Medicine ER -