INTRAVENOUS MAGNESIUM-SULFATE FOR PREMATURE LABOR - COMPARISON BETWEEN TWIN AND SINGLETON GESTATIONS

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 dosi ng regimens reported for singletons. Outcomes were compared between ca ses of singleton gestations eligible for tocolysis and admitted immedi ately before and after each twin case. The standard loading dose in bo th 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 de mographics to a similar cohort of 48 singletons. Frequencies of side e ffects and durations of therapy were the same between the two groups. The number of days from beginning therapy until delivery was highly va riable but not significantly different for the twin and singleton grou ps (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 pr emature labor in singletons are equally safe and effective for twin ge stations.