American journal of perinatology
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Comparative Study
Effect of magnesium sulfate on fetal heart rate variability in preeclamptic patients during labor.
Forty-two preeclamptic patients between 36 and 41 weeks gestation were investigated for baseline fetal heart rate (FHR) variability 1 hour after the initiation of magnesium therapy, at midlabor, and at the time of delivery. With a standard regimen of intravenous magnesium sulfate therapy, the mean maternal serum magnesium levels at the three different sampling times were statistically different (f = 6.94, p less than 0.01 by one-way analysis of variance), documenting the cumulative effect of continuous intravenous magnesium administration. ⋯ A higher mean maternal magnesium level, a higher mean cord blood magnesium level, and a higher total dose of magnesium sulfate were observed in the group of fetuses showing a decrease in FHR variability than in the group showing no change in FHR variability. The good fetal outcome seen in both study populations suggests that the effect of magnesium sulfate on FHR variability is a transient, reversible phenomenon that should not be considered as a sign of fetal distress.
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An abdominal gunshot wound in pregnancy warrants prompt surgical exploration but does not mandate uterine evacuation. Despite an entry and exit bullet wound to the uterus an apparent desire for pregnancy termination, a conservative approach was adopted with primary repair of the uterus, in conjunction with surgical repair of associated injuries.