СХЕМА 12. Применение сернокислого магния при преждевременных родах

Нагрузочная доза

Медленно (в течение 10—20 мин) внутривенно ввести 4 г препарата (40 м.т 10% раствора)

Поддерживающая доза

200 мл 10% раствора сернокислого магния добавить к 800 мл 5% раствора. декстрозы в воде и давать из расчета 100 мл/ч (2 г/ч)

Ежечасный мониторный контроль

а. Выделение мочи (должно быть не менее 30 мл/ч)

б. Глубокие сухожильные рефлексы (должны определяться 1+ до 2+)

и. Частота дыхания (должна быть не менее 15 в минуту)

Токсичность

Для нейтрализации токсического действия сернокислого магния ввести внут­ривенно медленно (в течение 5 мин) 1—2 г глюконата кальция

Содержание в крови

Терапевтический уровень — от 3 до 4 ммоль/л (6—8 мэкв/л) Отсутствие глубоких сухожильных рефлексов — 5 ммоль/л (10 мэкв/л) Расстройство дыхания — 6 ммоль/л (12 мэкв/л)

СПИСОК ЛИТЕРАТУРЫ

¹ 1. Anderso\A. [). М., Turnbull А. С. Relationship between length of gestationr and cervikal dilation, uterine contractions and other factors during preg' nancy. — Дгпег. J. Obstet. Gynec., 1969, 105, 1207.

2. Arias F.. K\ight A. The use of terbutaline in the management of premature labor.—In: Weld's Controversy in Obstetrics and Gynecology/Eds. F. P, Zuspan, C. D,-Christian.—Philadelphia: W. B. Saunders Co., 1983, 31—34.

3. Arias F., Pineda!., Johnson L. W. Changes in amniotic fluid lecithin/sphyn-gomyelin ratio ind dipalmitoy] lecithin associated with maternal betametha-sone therapy. — Amer. J. Obstet. Gynec., 1979, 133, 894.

4. Arias F., Tomich P. Etiology and outcome of low birth weight and pre-term infants. — Obstet. and Gynec., 1982, 60, 277.

5. Baird D. Environmental and obstetrical factors in prematurity with special-' reference to the experience in Aberdeen. — Bull. WHO, 1962, 26, 291.

6. Bobitt J. R„ Ledger W. S. Amniotic fluid analysis: its role in maternal and neonatal infection.—Obstet. and Gynec., 1978, 51, 56.

7. Bowes W. Л., Halgrison M: Simmons M. A. Results of the intensive perina­tal management of viry-low-weight infants (500 to 1500 groms).—J. Re-prod. Med., 1979, 23, 245.

8. Bruns P. D; Taylor E. S., Anker R. M. et al. Uterine contractility, circulati­on, and urinary steroids in premature delivery.—Amer. J. Obstet. Gynec.,. 1957, 73, 579.

9. Butler N.. Bonham D. Perinatal mortality.—Edinburgh: E. and S. Living-stone., 1963, 288.

10. Depp /?., Boehm J. S., Nosek /. A. et al. Antenatal corticosteroids to prevent:

neonatal respiratory distress syndrome: risk versus benefit considerations. — Amer. J. Obstet. Gynec., 1980, 137, 338.

11. Drillien M. D. Prenatal and perinatal factors in etiology and outcome of low birth weight.—Clin. Perinatol., 1974, 1, 197.

12. Dubowitz L. M. S., Dubowitz V., Goldberg C. G. Clinical assessment of gc-stational age in the newborn infant.—J. Pediat., 1970, 77, 1

13. Fedrick J., Anderson A. B. M. Factors associated with spontaneous pre-term birt. — Brit. J. Obstet. Gynec., 1976, 83, 342.

14. Fox H. The placenta in premature onset of labor.—Brit. J. Obstet. Gynec., 1969, 76, 240.

15. Friedman E. A., Neff R. К. Pregnancy Hypertension.—Littleton, Mass.:

PSG Publishing Co. Inc., 1977, 62, 200.

16. Fuchs F. Prevention of prematurity. Amer. J. Obstet. Gynec. 1976, 126, 809.

17. Fujimura M., Salisbury D. M., Robinson R. 0. et al. Clinical events relating to intraventricular hemorrhage in the newborn.—Arch. Dis, Child., 1979, 54, 409.

18. Funderburk S. J., Guthrie D., Maldrum D. Suboptimal pregnancy outcome-among women with prior obartions and premature births.—Amer. J. Ob­stet. Gynec., 1976, 126, 55.

19. Cluck L., Kulovich M. V., Borer R. C. et al Diagnosis of the respiratory di­stress syndrome by amniocentesis.—Amer. J. Obstet. Gynec., 1971, 109,. 440.

20. Goodlin R. C. Cervical incompetence, hourglass membranes, and amniocen­tesis. — Obstet. and Gynec., 1979, 54, 748.

21. Goodlin R. C; Keller D. W., Raffin M. Orgasm during late pregnancy: pos­sible deleterious effect — Obstet. and Gynec., 1971, 38, 916.

22. Haesslein H. C., Goodlin R. C. Delivery of the tiny newborn. Amer. Obstet. Gynec., 1979, 134, 192.

23. Heionen 0. Р., Slone D., Monson R. R. et al. Cardiovascular birth defects -and antenatal exposure to female sex hormone.—New Engl. J. Med, 1977, 296,67.

24. Herron M. A., Katz M., Creasy R. K. Evaluation of a preterm birth preven­tion program: preliminary report.—Obstet. and Gynec., 1982, 59, 452.

25. Howie R. N., Liggins G. C. Clinical trial of betamcthasone therapy for pre­vention of respiratory distress in preterm infants. — In: Preterm Labor./Eds.

A. Anderson, R. Beard, J. M- Brudenell et al.—London: Royal College of Obstetricians and Gynecologists, 1977, 281.

.26. Jacobs M. M., Arias F. Maternal pulmonary edema resulting/from betaini-metic and glucocorticoid therapy. — Obstet. and Gynec., 1980, 55, 56.

.27. Johnson J. W., Austin К. L.. Jones G. S. et al. Efficacy of 17-a-hydrxy pro­gesterone caproate in the prevention of premature labor. ^— New Engl. J. Med., 1975, 293—675.

'28. Kaas E. H. Pregnancy, pyelonephritis and prematurity. — Clin. Obstet. Gy­nec., 1970, 13, 239.

-29. Kaufman R., Binder G; Gray P. et al. Upper genital tract changes associa­ted with "in utero" exposure to diethylstilbestrol.—Amer. J. Obstet. Gynec.. 1977, 128, 51.

30. Kulovich M. V.. Hallman M. В.. Cluck L. The lung profile: I. Normal Preg­nancy.—Amer. J. Obstet. Gynec., 1979, 135, 57.

:31. Kulovich M. V., Gluck L. The lung profile: II. Complicated pregnancy.— Amer. J. Obstet. Gynec., 1979, 135, 64.

32. Lubchenco L. 0., Searls D. Т.. Braie J. V. Neonatal mortality rate: relation­ship to birth weight and gestational age.—J. Pediat. 1972, 81, 814.

,33. Martin С. V., Siassi В., Hon W. H. Fetal heart rate patterns and neonatal death in low birthweight infants.—Obstet. and Gynec., 1974. 44, 503.

34. Naeye R. L. Coitus and associated amniotic-fluid-infections.—New Engl. J. Med., 1979, 301, 1198.

35. Rush R. W„ Davey D. A., Segal M. L. The effect of pre-term delivery on perinatal mortality. — Brit. J. Obstet. Gynec., 1978, 85, 806.

36. Rush R. W., Keirse M. J. N. C., Howat P. et al. Contribution of pre-term delivery to perinatal mortality. — Brit. Med. J., 1976, 2, 965.

37. Safarti P., Pageant G; Gauthler С. Le role de 1'infection dans les avorte-ments tardifs et les accouchements prematures.—Can. Med. Assoc. J., 1968, 13. 1079.

38. Sher G., Stafland В. E., Freer В. E. et al. Assessing fetal lung maturation by the Foam Stability Index test. — Obstet. and Gynec., 1978, 52, 673.

39. Sher G., Startland В. E.. Knutzen V. K. Evaluation of the small third-tri. mester fetus usig the Foam Stability Index.—Obstet. and Gynec., 1981, 58, 314.

40. Stewart At., Turcan D. M.. Rawlings G. et al. Prognosis for infants weighing 1000 grams or less at birth. —Arch. Dis. Childh., 1977, 52, 97.

41. Tamby Raja R. L., Atputharajah V., Salmon Y. Prenention of prematurity in twins.—Aust. NZ. J. Obstet. Gynec., 1978, 18, 179.

42. Torday J., Carson L., Lawson E. E. Saturated phosphatidylcholine in amnio-tic fluid and prediction of the respiratory distess syndrome.—New Engl. J. Med., 1979, 301, 1013.

43. Voipe J. S. Perinatal hypoxic-ischemic brain injury.—Pediat. Clin. N. Amer., 1976,23, 383.

44. Weekes A. R..L., Flynn M. J. Engagement of the fetal head in primigravides and its relationship to duration of gestation and time of onset of labor. —• Brit. J. Obstet. Gynec., 1975, 82, 7.

45. Woods С., Bannerman R. H. 0., Booth R. T. et al. The prediction of prema­ture labor by observation of the cervix and external tocography. — Amer. J. Obstet. Gynec., 1965, 91, 396.

46. Zuckerman H., Reiss M., Rubinstein I. Inhibition of human premature la­bor by indomethacin. — Obstet. and Gynec., 1974, 44, 787.

От исполнителя

Должность

__________________В.И.Кулаков

М.П.