ABSTRACT
Premature labor occurs frequently in twin gestations, and intravenous magnesium sulfate
is commonly prescribed for tocolysis. The purpose of the present investigation was
to determine the efficacy and safety of intravenous magnesium sulfate tocolysis in
twin gestations using dosing regimens reported for singletons. Outcomes were compared
between cases of singleton gestations eligible for tocolysis and admitted immediately
before and after each twin case. The standard loading dose in both groups was 4 to
6 g intravenously with a maintenance dose of 1 to 3 g/hr. Data were compared using
unpaired ttests or chi-square analysis where appropriate. The 24 evaluable cases of
twins were similar in demographics to a similar cohort of 48 singletons. Frequencies
of side effects and durations of therapy were the same between the two groups. The
number of days from beginning therapy until delivery was highly variable but not significantly
different for the twin and singleton groups (13.5 ± 14.8 vs 20.9 ± 20.1 days, mean
± SD). No significant differences were found between the twin and singleton groups
in delays in delivery during the first 72 hours (16 [66.7%] vs 35 [72.9%]) and by
the 33rd completed week (10 [41.6%] vs 25 [52.1%]). In conclusion, guidelines for
prescribing intravenous magnesium sulfate to inhibit premature labor in singletons
are equally safe and effective for twin gestations.
Keywords
Magnesium sulfate - premature labor - twins
